ESPN 54th Annual Meeting

ESPN 2022


 
Renal involvement in chronic inflammatory bowel diseases: a series of pediatric cases in France
RYM KHELLAF 1 CHRISTINE PIETREMENT 1 AURELIE PONS 1

1- CHU DE REIMS
 
Introduction:

Inflammatory bowel diseases (IBD), including Crohns disease, ulcerative colitis and unclassified colitis, are multisystem diseases. Renal manifestations are not uncommon, and heterogeneous, inaugural or not, caused by IBD itself, their complications, or their treatments. Despite the frequency of IBD in children, there are few data on IBD-related renal damage in this population. The aim of this study is to describe these renal disorders in a series of pediatric IBD cases, in order to highlight the diagnostic and therapeutic difficulties.

Material and methods:

This study is a retrospective observational study of a series of pediatric cases collected after a call for observations to pediatric nephrologists of the Society of Pediatric Nephrology and the French Group of Pediatric Gastro-Enterology and Hepatology.

Results:

We present the preliminary results of the ongoing study of 6 patients in 5 hospitals in France. 5/6 patients had Crohns disease. 4/6 were treated with PENTASA(1 associateed with Infliximab), 1 with Vedolizumab, and 1 was not treated. Renal involvement manifested as acute kidney injury in all patients and occurred at the same time as digestive manifestations in two cases. Proteinuria and hematuria were not always present. When performed (3 cases), renal biopsy revealed serious tubulointerstitial nephritis. The renal lesions were treated with corticosteroids or simply monitored. 3 cases were attributed to a iatrogenic cause, and IBD treatment was suspended (PENTASA 2/6, VEDOLIZUMAB 1/6). During follow-up, renal function normalized in 2/6 patients, and 4/6 kept chronic kidney disease of varying severity.

Conclusions:

The etiological diagnosis of IBD-related kidney damage remains very difficult and often unclear in clinical practice, which makes therapeutic decisions difficult and may delay diagnosis and management, increasing the risk of renal sequels.