Minimal renal dysfunction in inflammatory bowel disease is related to disease activity but not to 5-ASA use

Citation
Kr. Herrlinger et al., Minimal renal dysfunction in inflammatory bowel disease is related to disease activity but not to 5-ASA use, ALIM PHARM, 15(3), 2001, pp. 363-369
Citations number
31
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Pharmacology,"da verificare
Journal title
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
ISSN journal
0269-2813 → ACNP
Volume
15
Issue
3
Year of publication
2001
Pages
363 - 369
Database
ISI
SICI code
0269-2813(200103)15:3<363:MRDIIB>2.0.ZU;2-W
Abstract
Background: Conflicting data exist about proteinuria in inflammatory bowel diseases. It is still unclear whether the occurrence of proteinuria in infl ammatory bowel disease patients is an extra-intestinal manifestation of dis ease or the result of adverse effects to medication, especially to aminosal icylates (ASA). Methods: A total of 95 patients (51 with Crohn's disease and 44 with ulcera tive colitis) were enrolled in the study. Disease activity was assessed by Crohn's Disease Activity Index (CDAI) or the Truelove index, respectively. Urine was collected over 24 h and protein excretion of specific marker prot eins for tubular (alpha1-microglobulin-alpha1-MG) and glomerular (albumin-A lb, Immunoglobulin G-IgG) dysfunction was measured using a highly sensitive immunoluminometric assay. Results: Out of 51 Crohn's disease patients, 20 showed elevated urinary alp ha1-MG. The amount of alpha1-MGuria was strongly correlated to the CDAI (r = 0.6, P < 0.001). Only four Crohn's disease patients showed slightly eleva ted values for glomerular proteins in urine. Similar results were obtained for ulcerative colitis: whereas only two ulcerative colitis patients showed albuminuria, tubular proteinuria was detected in 28 out of 44 ulcerative c olitis patients. Proteinuria was strongly dependent on disease activity (P < 0.01) but was not related to ASA treatment. Conclusions: Proteinuria of tubular marker proteins occurs in the majority of inflammatory bowel disease patients and is related to disease activity r ather than to ASA treatment. Tubular proteinuria seems to reflect a renal e xtra-intestinal manifestation of inflammatory bowel disease and may serve a s a new relevant marker of disease activity.