The following is a summary of “Absolute and Relative Risks of Kidney and Urological Complications in Patients With Inflammatory Bowel Disease,” published in the January 2024 issue of Gastroenterology by Yang, et al.
The extent of kidney and urological complications among individuals with inflammatory bowel disease (IBD) is not well understood. For a study, researchers sought to analyze the association between the development of IBD and the relative risks of chronic kidney disease (CKD), acute kidney injury (AKI), kidney stones, and clinically relevant declines in estimated glomerular filtration rate (eGFR) in a large cohort seeking healthcare in Stockholm, Sweden, from 2006 to 2018.
The analysis involved 1,682,795 individuals, treating IBD as a time-varying exposure. The study assessed the risks of receiving diagnoses for CKD, AKI, kidney stones, and experiencing a clinically relevant decline in eGFR (CKD progression). A parallel matched cohort of IBD cases and random controls matched at a ratio of 1:5 based on sex, age, and eGFR, was used to quantify 5- and 10-year absolute risks for these complications.
Over a median of 9 years, 10,117 participants developed IBD. Incident IBD was associated with higher risks of kidney-related complications compared to non-IBD periods. The hazard ratio (HR) for receiving a CKD diagnosis was 1.24 (95% CI: 1.10–1.40), and for CKD progression, it was 1.11 (95% CI: 1.00–1.24). The 10-year absolute risks for CKD events among IBD cases were 11.8%, with 6.4% receiving a CKD diagnosis and 7.9% experiencing CKD progression. Elevated risks were also observed for AKI (HR: 1.97, 95% CI: 1.70–2.29, 10-year absolute risk: 3.6%) and kidney stones (HR: 1.69, 95% CI: 1.48–1.93, 10-year absolute risk: 5.6%). Similar risks were identified for both Crohn’s disease and ulcerative colitis.
More than 10% of IBD patients developed CKD within 10 years of diagnosis, with many cases going undetected through diagnostic codes. Elevated risks of AKI and kidney stones emphasized the necessity for established protocols for kidney function monitoring and referrals to nephrological/urological care for individuals with IBD.
Source: journals.lww.com/ajg/abstract/2024/01000/absolute_and_relative_risks_of_kidney_and.21.aspx