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Effects of 5-aminosalicylate nephrotoxicity in IBD

May's issue of Alimentary Pharmacology and Therapeutics estimates the incidence of clinical nephrotoxicity in patients taking 5-aminosalicylate therapy to be 1 in 4000 patients per year and advises regular renal function monitoring for early detection.

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Dr Muller and colleagues from England studied 5-aminosalicylate nephrotoxicity in patients with inflammatory bowel disease in the UK.

The investigative team sent out a detailed postal questionnaire to all 1298 names in the British Society of Gastroenterology database and 290 consultant members of the Renal Association.

The British Society of Gastroenterology reported new cases monthly, the Renal Association 6 monthly and the team expressed results as estimated glomerular filtration rate.

The team reported that a retrospective study of cases included 202 cases from the British Society of Gastroenterology and 87 from the Renal Association with ages ranging from 15 to 76 years.

The investigators found that the median range of creatinine was 78 to 1200 μmol/L.

Renal function improves particularly for patients treated for less than 12 months
Alimentary Pharmacology and Therapeutics

The team also conducted a prospective study including 59 cases of 47 males and 12 females with a median age of 52 years.

The research team noted that the median pre-treatment estimated glomerular filtration rate was 77, with 28 at diagnosis and 47 at recovery.

The researchers observed that recovery of renal function was significantly improved for patients treated for less than 12 months.

The median recovery estimated glomerular filtration rate of 10 patients treated for less than 12 months was 71 versus 38 for those patients treated for more than 12 months.

Dr Muller's team concludes, “Regular monitoring of renal function may allow earlier detection of nephrotoxicity, particularly during the first year of therapy.”

“The prevalence of inflammatory bowel disease in the UK is 4,120,0000 of which 50% receive treatment.”

“We estimate that the incidence of clinical nephrotoxicity in patients taking 5-aminosalicylate therapy is approximately 1 in 4000 patients/year.”

Aliment Pharmacol Ther 2005: 21(10): 1217
16 May 2005

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