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Significant kidney impairment in pediatric inflammatory bowel disease and practice points for pediatric

Stephanie A Vuijk1, Renz C W Klomberg1, Tobias Schwerd2

  • 1Department of Pediatric Gastroenterology, Erasmus Medical Centre - Sophia Children's Hospital, Rotterdam, The Netherlands.

Journal of Pediatric Gastroenterology and Nutrition
|March 10, 2026
PubMed

Insights

Children with inflammatory bowel disease (IBD) face higher risks of kidney disorders. This study identified significant kidney function impairment (SKI) causes and offers recommendations for pediatric gastroenterologists to improve care for these patients.

Area of Science:

  • Pediatric Nephrology
  • Gastroenterology
  • Inflammatory Bowel Disease Research

Background:

  • Children with inflammatory bowel disease (IBD) exhibit an elevated risk of developing kidney disorders.
  • Significant kidney function impairment (SKI) and chronic kidney disease (CKD) are potential complications in pediatric IBD patients.

Purpose of the Study:

  • To investigate the causes and diagnostic challenges of SKI in children with IBD.
  • To develop evidence-based recommendations for screening, follow-up, and referral of pediatric IBD patients with SKI.

Main Methods:

  • Prospective data collection of SKI cases in children (<19 years) with IBD via the PIBD-SETQuality Safety Registry.
  • Monthly surveys to report SKI (eGFR < 60 mL/min/1.73 m²), followed by expert panel review for etiological assessment and recommendation formulation.

Main Results:

  • Analysis of 42 SKI cases revealed tubulo-interstitial nephritis (TIN) as the most frequent diagnosis (n=15).
  • Renal biopsy confirmed diagnoses in 38% of cases (10 TIN). Twelve patients progressed to CKD.
  • IBD medication was the most reported cause, though expert consensus on etiology was low (Fleiss' kappa 0.143, 0.102).

Conclusions:

  • This is the first prospective study detailing SKI in pediatric IBD patients, highlighting its potential to lead to CKD.
  • Determining the precise etiology of SKI in this population presents significant challenges.
  • The study provides crucial recommendations for managing and monitoring SKI in children with IBD.
Abstract

Keywords:
Crohn's diseaserenalulcerative colitis

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