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Kidney Week

Abstract: SA-PO442

Renal Involvement of Inflammatory Bowel Diseases in Children and Adolescents: From Korean Pediatric IBD Cohort

Session Information

  • Pediatric Nephrology - II
    October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1600 Pediatric Nephrology

Authors

  • Cho, Min Hyun, Kyungpook National University Hospital, Daegu, Korea (the Republic of)
  • Jung, Jaehun, Kyungpook National University Hospital, Daegu, Korea (the Republic of)
  • Baek, Hee Sun, Kyungpook National University Hospital, Daegu, Korea (the Republic of)
  • Cho, Heeyeon, Samsung Medical Center, Seoul, Korea (the Republic of)
  • Lee, Yeonhee, Samsung Medical Center, Seoul, Korea (the Republic of)
Background

Recently, the incidence of inflammatory bowel disease (IBD) has been rising rapidly, and several reports have described renal complications of IBD. We evaluated the clinical manifestations of renal complications in children with IBD to enable early detection and prompt treatment of renal complications.

Methods

We retrospectively reviewed the medical records of 456 children and adolescents aged <20 years who had been diagnosed with IBD since 2000. We analyzed age, sex, medication use, IBD disease activity, and clinical manifestations of renal symptoms.

Results

Our study comprised 456 children with IBD including 299 boys (65.6%) and 157 girls (34.4%) with a mean age±SD of 14±3 years. The mean follow-up period was 4.61±2.93 years. The study included 346 children with Crohn's disease (CD, 75.9%) and 110 with ulcerative colitis (UC, 24.1%), and the incidence of CD was >UC. Among the 456 children studied, 67 (14.7%) showed confirmed renal manifestations, and 59 were identified as children with CD and 8 as children with UC. We observed 26 children (38.8%) with isolated hematuria, 30 (44.8%) with isolated proteinuria, and 11 (16.4%) with hematuria and concomitant proteinuria. A renal biopsy was performed in 7 children with CD. Of them, 5 children showed both microscopic hematuria and proteinuria. Persistent microscopic hematuria and recurrent gross hematuria was observed in 2 children. Histopathological examination revealed IgA nephropathy in 5 children (71.4%) and Henoch-Schönlein purpura (HSP) nephritis in 1 child (14.2%), whereas 1 child (14.2%) showed no histopathological abnormalities. IBD disease activity was evaluated in 102 children, of which 81 showed CD and 21 showed UC. No significant correlation was observed between the IBD disease activity and the presence of renal manifestations in 102 children in whom we were able to assess disease activity. In all 102 children, disease activity was mild, and the disease was well controlled.

Conclusion

Children with IBD are more likely to show kidney-related symptoms than healthy children and adolescents. Therefore, regular screening of urine and evaluation of renal function are necessary for early detection of renal complications.