Abstract Background Renal and urological manifestations are established but insufficiently investigated extraintestinal manifestations of inflammatory bowel disease (IBD). The aim of this study was to determine their prevalence and to investigate associations with clinical factors. Methods This was a retrospective, observational study, conducted at a tertiary center in Greece. IBD patients with at least one year of follow-up and documented renal function and disease activity were included. Demographic, clinical, and laboratory data were retrieved. The primary outcome was the composite outcome of kidney injury acute kidney injury (AKI) and/or chronic kidney disease (CKD) during follow-up. Secondary outcomes were AKI, CKD, and urolithiasis. Associations with independent variables were examined using univariate logistic regression; a multivariable analysis was performed for the primary outcome. Results A total of 660 IBD patients were included in this study 379 (57.4%) male, 368 (56%) Crohn’s disease (CD), 292 (44%) Ulcerative Colitis (UC) (Table 1). Kidney injury occurred in 54 patients (8.3%), AKI in 23 (3.5%), CKD in 35 (5.3%), and urolithiasis in 48 (7.3%). Independent risk factors for renal injury were IBD-related surgery adjusted Odds Ratio (aOR) 2.69, 95% Confidence Interval (CI): 1.25–5.80, p = 0.012, male sex (aOR 2.14, 95% CI: 1.06–4.32, p = 0.034), Charlson Index (per 1-point increase, aOR 1.53, 95% CI: 1.26–1.86, p 0.001) and arterial hypertension (aOR 2.43, 95% CI: 1.20–4.94, p = 0.014) (Table 2). Extensive UC also independently predicted renal injury (aOR 2.81, 95% CI: 1.11–7.73, p = 0.035). AKI was associated with older age at IBD onset and a higher number of IBD flares. All secondary outcomes correlated with hypertension and dyslipidemia. Conclusion Renal and urological complications are relatively common in IBD affecting 8.3% and 7.3% of patients respectively. IBD-related surgery, extensive UC, and comorbidities significantly increase the risk of renal injury. These findings underscore the need for regular renal monitoring in IBD patients. References: 1. Zadora W, Innocenti T, Verstockt B, Meijers B. Chronic Kidney Disease in Inflammatory Bowel Disease: a Systematic Review and Meta-analysis. J Crohns Colitis. 2024;18(9):1464-1475. doi:10.1093/ECCO-JCC/JJAE049 2. van Hoeve K, Hoffman I. Renal manifestations in inflammatory bowel disease: a systematic review. J Gastroenterol. 2022;57(9):619-629. doi:10.1007/S00535-022-01903-6 3. Dincer MT, Dincer ZT, Bakkaloglu OK, et al. Renal Manifestations in Inflammatory Bowel Disease: A Cohort Study During the Biologic Era. Med Sci Monit. 2022;28. doi:10.12659/MSM.936497 Conflict of interest: Psarakis, Georgios: No conflict of interest Drygiannakis, Ioannis: No conflict of interest Foteinogiannopoulou, Kalliopi: No conflict of interest Orfanoudaki, Eleni: No Karmiris, Konstantinos: Personal Fees: Speaker fees from Abbvie, BMS, Eli-Lilly, Genesis, Innovis, Johnson & Johnson, Pfizer and consultancy or advisory board member fees from Abbvie, BMS, Faran, Ferring, Genesis, Johnson & Johnson, Pfizer, Roche and Takeda Haidich, Anna-Bettina: No conflict of interest Koutroubakis, Ioannis E.: No conflict of interest
Psarakis et al. (Thu,) studied this question.