World J Gastroenterol. 2018;24(42):4798-4808.

Increased end-stage renal disease risk in patients with inflammatory bowel disease: A nationwide population-based study.

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제1저자 박선아 · 교신저자 김주성

PMID 30479466 PMC6235796 DOI 10.3748/wjg.v24.i42.4798 IF 7.7 소화기내과

소속 (5)

Department of Internal Medicine, Liver Research Institute, Seoul National University College of Medicine, Seoul 03080, South Korea.
Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea.
Department of Internal Medicine, CHA Gangnam Medical Center, CHA University, Seoul 06135, South Korea.
Department of Internal Medicine and Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul 06236, South Korea.
Department of Internal Medicine, Liver Research Institute, Seoul National University College of Medicine, Seoul 03080, South Korea. jooskim@snu.ac.kr.

Abstract

AIM To estimate the risk of end-stage renal disease (ESRD) in patients with inflammatory bowel disease (IBD).

METHODS From January 2010 to December 2013, patients with Crohn's disease (CD) and ulcerative colitis (UC) were identified, based on both the International Classification of Diseases, 10^th revision (ICD-10) and the rare, intractable disease registration program codes from the National Health Insurance (NHI) database in South Korea. We compared 38812 patients with IBD to age- and sex-matched non-IBD controls with a ratio of 1:3. Patients newly diagnosed with ESRD were identified with the ICD-10 code.

RESULTS During a mean follow-up of 4.9 years, ESRD was detected in 79 (0.2%) patients with IBD and 166 (0.1%) controls. The incidence of ESRD in patients with IBD was 0.42 per 1000 person-years. Patients with IBD had a significantly higher risk of ESRD than controls [adjusted hazard ratio (HR) = 3.03; 95% confidence interval (CI): 1.77-5.20; P < 0.001]. The incidences (per 1000 person-years) of ESRD were 0.51 in patients with CD and 0.13 in controls, respectively (adjusted HR = 6.33; 95%CI: 2.75-14.56; P < 0.001). In contrast, the incidence of ESRD was similar between the UC and control groups (0.37 vs 0.37 per 1000 person-years; adjusted HR = 2.01; 95%CI: 0.90-4.51; P = 0.089).

CONCLUSION The risk of ESRD was elevated in patients with CD, but not UC. Patients with CD should be monitored carefully for signs of renal insufficiency.

Keywords

Claims dataCrohn’s diseaseEnd-stage renal diseaseInflammatory bowel diseaseUlcerative colitis

Figures

**Figure 1** Kaplan-Meier plots show the cumulative incidence of end-stage renal disease in patients with inflammatory bowel disease. A: All patients with inflammatory bowel disease; B: Patients with Crohn’s disease; C: Patients with ulcerative colitis. CD: Crohn’s disease; ESRD: End-stage renal disease; IBD: Inflammatory bowel disease; UC: Ulcerative colitis.

**Figure 2** Analysis of end-stage renal disease in subgroups of patients with inflammatory bowel disease. The cohort was divided into patients with (A) Crohn’s disease or (B) ulcerative colitis. Subgroups included younger/older age, male/female sex, patients that were/were not metabolically healthy (defined as the absence of diabetes mellitus, hypertension, and dyslipidemia), and patients with/without underlying disease (defined as the presence of at least one of the following: diabetes mellitus, hypertension, dyslipidemia, congestive heart failure, ischemic heart disease, or hyperuricemia and gout). CD: Crohn’s disease; CI: Confidence interval; ESRD: End-stage renal disease; UC: Ulcerative colitis.

그림 출처: PubMed Central 공개 논문 (PMC6235796)

Conflict of interest statement

Conflict-of-interest statement: The authors declare that they have no conflict of interest.

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