Kidney Biopsy Findings and Clinical Outcomes of US Veterans with Inflammatory Bowel Disease
Introduction: Patients with inflammatory bowel disease (IBD; ulcerative colitis [UC] and Crohn’s disease [CD]) may have unique patterns of kidney injury related to their underlying or coexisting disease or to medications. We present the kidney biopsy findings and clinical outcomes of veterans with U...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Karger Publishers
2023-09-01
|
| Series: | Glomerular Diseases |
| Subjects: | |
| Online Access: | https://beta.karger.com/Article/FullText/534062 |
| _version_ | 1797649347494543360 |
|---|---|
| author | Prasanth Ravipati Scott Reule Alyssa Bren Lihong Bu Byron P Vaughn Patrick H. Nachman |
| author_facet | Prasanth Ravipati Scott Reule Alyssa Bren Lihong Bu Byron P Vaughn Patrick H. Nachman |
| author_sort | Prasanth Ravipati |
| collection | DOAJ |
| description | Introduction: Patients with inflammatory bowel disease (IBD; ulcerative colitis [UC] and Crohn’s disease [CD]) may have unique patterns of kidney injury related to their underlying or coexisting disease or to medications. We present the kidney biopsy findings and clinical outcomes of veterans with UC or CD from the US Department of Veteran’s Affairs (VA) health system. Methods: Histopathologic and clinical data were extracted by retrospective review of the VA electronic health record of patients with IBD and a kidney biopsy between 2000 and 2018. Incident end-stage kidney disease (ESKD) was defined as requirement of kidney replacement therapy. Statistical analyses were performed using SAS. Results: A total of 140 patients (UC: 91 and CD: 49) underwent kidney biopsy. The three most common diagnoses were IgA nephropathy (17.1%), diabetic nephropathy (14.3%), and acute interstitial nephritis (9.3%). Significant interstitial fibrosis, tubular atrophy, and arteriosclerosis were present in 45% of biopsies. Twenty-six percent of patients with UC and 20% of those with CD progressed to ESKD, with a mean time from kidney biopsy of 3.1 and 1.9 years, respectively. Forty-five percent of patients with UC and 34% of those with CD died, with a mean time from kidney biopsy of 4.3 and 4.6 years, respectively. Conclusion: Among US veterans with IBD who underwent a kidney biopsy, IgA nephropathy, diabetic nephropathy, and interstitial nephritis were among the most common findings. Additionally, features of advanced kidney disease with rapid clinical progression to ESKD or death were observed. These findings suggest a delay and possibly a low rate of diagnosis. |
| first_indexed | 2024-03-11T15:44:52Z |
| format | Article |
| id | doaj.art-270a9542ba7c4ec7b08583ae7b3775b6 |
| institution | Directory Open Access Journal |
| issn | 2673-3633 |
| language | English |
| last_indexed | 2024-03-11T15:44:52Z |
| publishDate | 2023-09-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Glomerular Diseases |
| spelling | doaj.art-270a9542ba7c4ec7b08583ae7b3775b62023-10-26T06:38:33ZengKarger PublishersGlomerular Diseases2673-36332023-09-011110.1159/000534062534062Kidney Biopsy Findings and Clinical Outcomes of US Veterans with Inflammatory Bowel DiseasePrasanth Ravipati0Scott Reule1Alyssa Bren2Lihong Bu3Byron P Vaughn4Patrick H. Nachman5Division of Nephrology, Department of Medicine, University of Nebraska Medical Center, Omaha, NE, USADivision of Medicine, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USAUniversity of Minnesota Medical School, Minneapolis, MN, USADepartment of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USADivision of Gastroenterology and Hepatology, Department of Medicine, University of Minnesota, Minneapolis, MN, USADivision of Nephrology and Hypertension, Department of Medicine, University of Minnesota, Minneapolis, MN, USAIntroduction: Patients with inflammatory bowel disease (IBD; ulcerative colitis [UC] and Crohn’s disease [CD]) may have unique patterns of kidney injury related to their underlying or coexisting disease or to medications. We present the kidney biopsy findings and clinical outcomes of veterans with UC or CD from the US Department of Veteran’s Affairs (VA) health system. Methods: Histopathologic and clinical data were extracted by retrospective review of the VA electronic health record of patients with IBD and a kidney biopsy between 2000 and 2018. Incident end-stage kidney disease (ESKD) was defined as requirement of kidney replacement therapy. Statistical analyses were performed using SAS. Results: A total of 140 patients (UC: 91 and CD: 49) underwent kidney biopsy. The three most common diagnoses were IgA nephropathy (17.1%), diabetic nephropathy (14.3%), and acute interstitial nephritis (9.3%). Significant interstitial fibrosis, tubular atrophy, and arteriosclerosis were present in 45% of biopsies. Twenty-six percent of patients with UC and 20% of those with CD progressed to ESKD, with a mean time from kidney biopsy of 3.1 and 1.9 years, respectively. Forty-five percent of patients with UC and 34% of those with CD died, with a mean time from kidney biopsy of 4.3 and 4.6 years, respectively. Conclusion: Among US veterans with IBD who underwent a kidney biopsy, IgA nephropathy, diabetic nephropathy, and interstitial nephritis were among the most common findings. Additionally, features of advanced kidney disease with rapid clinical progression to ESKD or death were observed. These findings suggest a delay and possibly a low rate of diagnosis.https://beta.karger.com/Article/FullText/534062inflammatory bowel diseaseimmunoglobin a nephropathyhistopathology |
| spellingShingle | Prasanth Ravipati Scott Reule Alyssa Bren Lihong Bu Byron P Vaughn Patrick H. Nachman Kidney Biopsy Findings and Clinical Outcomes of US Veterans with Inflammatory Bowel Disease Glomerular Diseases inflammatory bowel disease immunoglobin a nephropathy histopathology |
| title | Kidney Biopsy Findings and Clinical Outcomes of US Veterans with Inflammatory Bowel Disease |
| title_full | Kidney Biopsy Findings and Clinical Outcomes of US Veterans with Inflammatory Bowel Disease |
| title_fullStr | Kidney Biopsy Findings and Clinical Outcomes of US Veterans with Inflammatory Bowel Disease |
| title_full_unstemmed | Kidney Biopsy Findings and Clinical Outcomes of US Veterans with Inflammatory Bowel Disease |
| title_short | Kidney Biopsy Findings and Clinical Outcomes of US Veterans with Inflammatory Bowel Disease |
| title_sort | kidney biopsy findings and clinical outcomes of us veterans with inflammatory bowel disease |
| topic | inflammatory bowel disease immunoglobin a nephropathy histopathology |
| url | https://beta.karger.com/Article/FullText/534062 |
| work_keys_str_mv | AT prasanthravipati kidneybiopsyfindingsandclinicaloutcomesofusveteranswithinflammatoryboweldisease AT scottreule kidneybiopsyfindingsandclinicaloutcomesofusveteranswithinflammatoryboweldisease AT alyssabren kidneybiopsyfindingsandclinicaloutcomesofusveteranswithinflammatoryboweldisease AT lihongbu kidneybiopsyfindingsandclinicaloutcomesofusveteranswithinflammatoryboweldisease AT byronpvaughn kidneybiopsyfindingsandclinicaloutcomesofusveteranswithinflammatoryboweldisease AT patrickhnachman kidneybiopsyfindingsandclinicaloutcomesofusveteranswithinflammatoryboweldisease |