Abstract: TH-PO599
Kidney Disease Outcomes in Patients with Inflammatory Bowel Disease
Session Information
- Glomerular Diseases: Clinical and Epidemiologic Studies
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Trials
Authors
- Saha, Manish K., University of North Carolina, Chapel Hill, North Carolina, United States
- Geetha, Duvuru, Johns Hopkins University, Baltimore, Maryland, United States
- Laurin, Louis-Philippe, Universite de Montreal, Montreal, Quebec, Canada
- Leclerc, Simon, Universite de Montreal, Montreal, Quebec, Canada
- Falk, Ronald, University of North Carolina, Chapel Hill, North Carolina, United States
- Hogan, Susan L., University of North Carolina, Chapel Hill, North Carolina, United States
- Mottl, Amy K., University of North Carolina, Chapel Hill, North Carolina, United States
- Hu, Yichun, University of North Carolina, Chapel Hill, North Carolina, United States
- Derebail, Vimal K., University of North Carolina, Chapel Hill, North Carolina, United States
Background
Patients with inflammatory bowel diseases (IBD), Crohn’s disease (CD) and ulcerative colitis (UC) may have extra-intestinal manifestations (EIM). The prevalence of histologic patterns of kidney disease seen in IBD patients is known, but clinical characteristics and long-term kidney outcomes remain ill-defined.
Methods
We performed a multi-center, retrospective, study of IBD patients who had a kidney biopsy across 3 centers. Inclusion criteria were: (i) IBD diagnosis based on clinical/histological characteristics and (ii) kidney biopsy with pathology report available. Baseline clinical data were analyzed for the whole cohort while outcomes were evaluated in those with available follow-up. Between groups, comparisons for continuous variables were made using Wilcoxon two-sample test and Fisher’s exact test for categorical values.
Results
The frequency of various glomerular (GN), tubulointerstitial (TIN), and vascular (VD) processes are listed in Table 1. Patients with VD were older compared to other groups. At presentation, proteinuria was higher in patients with GN compared to those with TIN [2.13 (0.84, 4.07) vs. 0.30 (0.25, 1.25) p<0.05] and kidney function was worse in those with TIN compared to GN (3.10 [1.98, 4.50] vs. 2.10 [1.20, 3.11], p=0.05]). TIN occurred in 3 treatment naïve patients. In median follow-up of >3 years, 6 of 35 (17%) GN patients, 1 of 8 (12.5%) TIN, and 2 of 4 (50%) VD patients developed ESKD.
Conclusion
Patients with IBD may have varying forms of CKD including GN, and routine monitoring of kidney function is essential for early diagnosis and treatment. TIN may occur as an EIM independent of sulfasalzine therapy. Future studies are required to understand plausible shared immunopathogenesis.
Table 1 Frequency of various kidney diseases in patients with IBD
| CD+UC+IBD@ n=96 | CD n=56 | UC n=36 | |
| IgAN FSGS Amyloidosis-MGRS ANCA-vasculitis Other GN | 18 10 8 8 12 | 11 6 5 3 5 | 6 3 3 5 7 |
| TIN | 14 | 8 | 5 |
| VD | 12 | 8 | 4 |
| Others | 9 | 6 | 3 |
@IBD - 4 patients had IBD without distinctive features of CD/UC -- 1 each had IgAN, FSGS,TIN, ATN 4 patients in CD and 1 in UC group had only ATN; MGRS=monoclonal gammopathy of renal significance, ANCA=Anti-neutrophil cytoplasmic antibody; Others: neoplasm, non-specific interstitial fibrosis