Renal involvement in paediatric inflammatory bowel disease

Abstract

Inflammatory bowel disease (IBD), which includes Crohn's disease, ulcerative colitis and inflammatory bowel disease unclassified, is a chronic inflammatory disorder that predominantly affects the gastrointestinal (GI) tract and has a rising incidence in both children and adults. Symptoms are caused by inappropriate inflammatory response triggered by interaction between the environment, gut microbiome and host immune system in a genetically susceptible individual. Extranintestinal manifestations of IBD are common and can affect any body system outside the gut; they can precede or run parallel to GI inflammation. Renal involvement in IBD is uncommon and can be part of extraintestinal manifestation or metabolic complications of IBD. Many medications used to treat IBD can cause renal damage. Renal manifestation in children with IBD can range from asymptomatic biochemical abnormalities to variable stages of renal impairment with significant morbidity and even mortality burden.

Ulcerative Colitis of the Neovagina in a Toddler with Cloaca and Chronic Kidney Disease

“…The structural renal anomalies most commonly identified are solitary kidney (13–26%), renal dysplasia (13–27%), ectopic kidney (8–14%), duplex kidneys (4–9%), hydronephrosis (16–58%), and ureteropelvic junction obstruction (5–8%). 19 Renal involvement is one of the extraintestinal manifestation of IBD that affects 4 to 23% of adults and 1 to 2% of children 20 and can present also as nephrolithiasis, tubulointerstitial nephritis, glomerulonephritis, and amyloidosis. 21 Many medications used in the treatment of IBD are known to have nephrotoxic adverse effects.…”

Astaxanthin Esters as Functional Food: A Review of Their Nutrition, Phytochemical Structure, Biological Features, and Food Industry Prospects

“…Inflammatory bowel disease (IBD) is a chronic intestinal disease that affects the intestinal mucosal immune system. 53 The incidence of IBD has increased in China, making it a common digestive system disorder. Currently, no specific drugs have been identified for the treatment of IBD, and Western medicine induces remission.…”

Kidney Diseases Associated With Inflammatory Bowel Disease: Impact of Chronic Histologic Damage, Treatments, and Outcomes

“… 1 , 2 , 3 Although the exact underlying pathogenic mechanisms remain largely unknown, evidence suggests that the disease may be primarily due to dysregulation of intestinal T-cells in genetically susceptible individuals, although idiosyncratic reactions to drugs, other environmental factors, and gut microbiota dysbiosis may also contribute to the disease. 1 , 4 , 5 , 6 …”

“…Kidney involvement has been described in 4% to 23% of patients with IBD and may be caused by several factors, including the primary systemic disease itself, secondary complications due to persistent chronic inflammation, malnutrition, dehydration episodes associated with intestinal losses, or drug-related side effects. 5 , 9 , 11 , 12 The most common causes of kidney injury in patients with IBD include urolithiasis, fistulas, and ureteral obstruction. 12 , 13 , 14 However, the spectrum of kidney diseases associated with IBD may be broader, including glomerular or interstitial diseases.…”

“…Kidney disease associated with IBD has a significant impact on patients’ quality of life and is associated with increased patient morbidity and even mortality. 5 , 9 , 11 , 15 Despite this, kidney outcomes of these patients and their main predictors have scarcely been evaluated.…”