Ileostomy and renal complications: a narrative review of current insights and challenges

Although ileosto my formation during colorectal surgery is often life-saving, it carries risks of complications, notably electrolyte disturbances, dehydration, and acute or chronic kidney injury. When an ileostomy enters the high-output state (HOS), challenging complications may follow and disrupt a patient’s quality of life. By conducting this review, we aim to explore the underlying mechanisms, risk factors, and clinical presentation of renal injury among ileostomy patients. We further discuss the current management strategies, including preventive methods, pharmacological interventions, dietary modifications, and surgical approaches, emphasizing the need for individualized care plans tailored to patient-specific needs. Surgical options beyond ileostomy reversal, such as stoma relocation or small bowel lengthening, are also reviewed for their potential to mitigate HOSs. Despite advancements, significant gaps remain, including the lack of standardized protocols and challenges with patient adherence to preventive measures. By overcoming these challenges, this study can set the cornerstone for future studies to achieve the optimal management of ileostomy-associated renal dysfunction, ultimately leading to an improved quality of life for the affected patients.