Review article
RENAL FUNCTION IN PATIENTS WITH INFLAMMATORY BOWEL DISEASES
JAKOB VRUS
; University of Zagreb, School of Medicine, Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, Zagreb University Hospital Centre, Zagreb, Croatia
NIKOLINA BAŠIĆ JUKIĆ
orcid.org/0000-0002-0221-2758
; University of Zagreb, School of Medicine, Department of Nephrology, Arterial Hypertension, Dialysis and Transplantation, Zagreb University Hospital Centre, Zagreb, Croatia
Abstract
The incidence of infl ammatory bowel diseases (IBD) has rapidly increased over the last few years, as have increased their
extraintestinal manifestations and systemic complications. Renal manifestations of IBD, although rare, can lead to chronic
renal failure and the need for renal replacement therapy with either dialysis or renal transplantation. Renal manifestations are
primarily renal calculi, which have a tendency of appearing up to fi ve times more frequently in IBD patients than in the general
population, but also parenchymal diseases as IgA nephropathy, tubulointerstitial nephritis and secondary amyloidosis.
Due to nephrotoxicity of cyclosporine and possible development of acute tubulointerstitial nephritis as a consequence
of mesalazine treatment, regular renal function monitoring is mandatory. New therapeutic options are being introduced
for secondary and tertiary prevention of oxalate stones (probiotics featuring Oxalobacter formigenes) and glomerular IgA
deposits (baminercept), with the intent of preserving renal homeostasis. Infl iximab can prevent further renal deterioration in
kidneys affected by amyloidosis. Furthermore, its use in patients on hemodialysis has been proven to be safe and necessary
if rapid suppression of intestinal infl ammation is required. Patients with IBD having undergone renal transplantation end
to have better outcomes compared to liver transplant recipients. This is postulated to be the effect of more intensive
immunosuppressive therapy in kidney recipients.
Keywords
inflammatory bowel disease; ulcerative colitis; Crohn’s disease; renal complications; kidney transplantation; hemodialysis
Hrčak ID:
256728
URI
Publication date:
28.4.2021.
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