Increased end-stage renal disease risk in patients with inflammatory bowel disease:A nationwide populationbased study
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摘要
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 ageand 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 was0.42 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 personyears)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.
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 ageand 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 was0.42 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 personyears)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.
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 ageand 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 was0.42 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 personyears)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.
引文
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2 Liyanage T,Ninomiya T,Jha V,Neal B,Patrice HM,Okpechi I,Zhao MH,Lv J,Garg AX,Knight J,Rodgers A,Gallagher M,Kotwal S,Cass A,Perkovic V.Worldwide access to treatment for end-stage kidney disease:a systematic review.Lancet 2015;385:1975-1982[PMID:25777665 DOI:10.1016/S0140-6736(14)61601-9]
3 Jha V,Garcia-Garcia G,Iseki K,Li Z,Naicker S,Plattner B,Saran R,Wang AY,Yang CW.Chronic kidney disease:global dimension and perspectives.Lancet 2013;382:260-272[PMID:23727169DOI:10.1016/S0140-6736(13)60687-X]
4 Saran R,Robinson B,Abbott KC,Agodoa LYC,Bhave N,BraggGresham J,Balkrishnan R,Dietrich X,Eckard A,Eggers PW,Gaipov A,Gillen D,Gipson D,Hailpern SM,Hall YN,Han Y,He K,Herman W,Heung M,Hirth RA,Hutton D,Jacobsen SJ,Jin Y,Kalantar-Zadeh K,Kapke A,Kovesdy CP,Lavallee D,Leslie J,McCullough K,Modi Z,Molnar MZ,Montez-Rath M,Moradi H,Morgenstern H,Mukhopadhyay P,Nallamothu B,Nguyen DV,Norris KC,O'Hare AM,Obi Y,Park C,Pearson J,Pisoni R,Potukuchi PK,Rao P,Repeck K,Rhee CM,Schrager J,Schaubel DE,Selewski DT,Shaw SF,Shi JM,Shieu M,Sim JJ,Soohoo M,Steffick D,Streja E,Sumida K,Tamura MK,Tilea A,Tong L,Wang D,Wang M,Woodside KJ,Xin X,Yin M,You AS,Zhou H,Shahinian V.US Renal Data System 2017 Annual Data Report:Epidemiology of Kidney Disease in the United States.Am J Kidney Dis 2018;71:A7[PMID:29477157 DOI:10.1053/j.ajkd.2018.01.002]
5 Lee SH,Kwon JE,Cho ML.Immunological pathogenesis of inflammatory bowel disease.Intest Res 2018;16:26-42[PMID:29422795 DOI:10.5217/ir.2018.16.1.26]
6 Berry SK,Melmed GY.Quality indicators in inflammatory bowel disease.Intest Res 2018;16:43-47[PMID:29422796 DOI:10.5217/ir.2018.16.1.43]
7 Katsanos KH,Papadakis KA.Inflammatory Bowel Disease:Updates on Molecular Targets for Biologics.Gut Liver 2017;11:455-463[PMID:28486793 DOI:10.5009/gnl16308]
8 Thia KT,Loftus EV Jr,Sandborn WJ,Yang SK.An update on the epidemiology of inflammatory bowel disease in Asia.Am JGastroenterol 2008;103:3167-3182[PMID:19086963 DOI:10.1111/j.1572-0241.2008.02158.x]
9 Kaplan GG,Ng SC.Understanding and Preventing the Global Increase of Inflammatory Bowel Disease.Gastroenterology 2017;152:313-321.e2[PMID:27793607 DOI:10.1053/j.gastro.2016.10.020]
10 Ng SC,Leung WK,Shi HY,Li MK,Leung CM,Ng CK,Lo FH,Hui YT,Tsang SW,Chan YK,Loo CK,Chan KH,Hui AJ,Chow WH,Harbord M,Ching JY,Lee M,Chan V,Tang W,Hung IF,Ho J,Lao WC,Wong MT,Sze SF,Shan EH,Lam BC,Tong RW,Mak LY,Wong SH,Wu JC,Chan FK,Sung JJ.Epidemiology of Inflammatory Bowel Disease from 1981 to 2014:Results from a Territory-Wide Population-Based Registry in Hong Kong.Inflamm Bowel Dis 2016;22:1954-1960[PMID:27416041 DOI:10.1097/MIB.0000000000000846]
11 Ng WK,Wong SH,Ng SC.Changing epidemiological trends of inflammatory bowel disease in Asia.Intest Res 2016;14:111-119[PMID:27175111 DOI:10.5217/ir.2016.14.2.111]
12 Pardi DS,Tremaine WJ,Sandborn WJ,McCarthy JT.Renal and urologic complications of inflammatory bowel disease.Am JGastroenterol 1998;93:504-514[PMID:9576439 DOI:10.1111/j.1572-0241.1998.156_b.x]
13 Skamnelos A,Giagkou E,Malakos Z,Katsanos K,Christodoulou D.Inflammatory Bowel Diseases Accompanied by Renal Impairment.J Clin Exp Nephrol 2015;1[DOI:10.21767/2472-5056.100001]
14 Primas C,Novacek G,Schweiger K,Mayer A,Eser A,Papay P,Gratzer C,Angelberger S,Dejaco C,Reinisch W,Vogelsang H.Renal insufficiency in IBD--prevalence and possible pathogenetic aspects.J Crohns Colitis 2013;7:e630-e634[PMID:23706934DOI:10.1016/j.crohns.2013.05.001]
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