Insights into renal and urological complications of inflammatory bowel disease.

Anmol Singh, Tejasvini Khanna, Diksha Mahendru, Jasraj Kahlon, Vikash Kumar, Aalam Sohal, Juliana Yang
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Abstract

Inflammatory bowel disease (IBD) is a chronic condition characterized by immune-mediated inflammation in the gastrointestinal tract, which follows a relapsing and remitting course. Apart from affecting the gastrointestinal tract, IBD also has extra-intestinal manifestations (EIMs). While the etiology of extraintestinal manifestation remains unclear, it is theorized to be based on immunological responses influenced by genetic factors. Renal involvement is one of the EIMs observed in ulcerative colitis and Crohn's disease. The renal manifestations in IBD patients encompass a range of conditions including nephrolithiasis, amyloidosis, tubulointerstitial nephritis, glomerulonephritis (GN), obstructive pathologies, and chronic kidney disease (CKD). The incidence of CKD in IBD patients varies from 5%-15%. The decline in renal function can stem from various factors such as direct inflammatory damage to the kidneys leading to glomerular or tubular injury, or from complications like recurrent stones, amyloidosis, or GN. Additionally, nephrotoxic medications used in treating IBD, such as TNF-α inhibitors, calcineurin inhibitors, and aminosalicylates, can exacerbate the decline in renal function. Currently, there is a lack of consensus regarding these patients' screening and renal function monitoring. This review aims to assess the existing literature on the different renal complications among individuals with IBD, shedding light on their pathophysiology and management.

对炎症性肠病肾脏和泌尿系统并发症的见解。
炎症性肠病(IBD)是一种以免疫介导的胃肠道炎症为特征的慢性疾病,病程呈复发性和缓解性。除了影响胃肠道外,IBD 还有肠外表现(EIMs)。虽然肠外表现的病因仍不清楚,但据推测是受遗传因素影响的免疫反应所致。肾脏受累是溃疡性结肠炎和克罗恩病的肠外表现之一。IBD 患者的肾脏表现包括肾结石、淀粉样变性、肾小管间质性肾炎、肾小球肾炎 (GN)、阻塞性病变和慢性肾脏病 (CKD)。IBD 患者中 CKD 的发病率为 5%-15%。肾功能下降可源于多种因素,如肾脏的直接炎症损伤导致肾小球或肾小管损伤,或并发症如反复结石、淀粉样变性或 GN。此外,治疗 IBD 的肾毒性药物(如 TNF-α 抑制剂、钙神经蛋白酶抑制剂和氨基水杨酸盐)也会加剧肾功能的衰退。目前,关于这些患者的筛查和肾功能监测还缺乏共识。本综述旨在评估有关 IBD 患者不同肾脏并发症的现有文献,揭示其病理生理学和管理方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
3.40
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