Case reports concerning irreversible renal failure caused by 5-aminosalicylates have been published.
Dr de Jong and colleagues investigated the effect of long-term use of 5-aminosalicylates on renal function in patients with Crohn's disease.
The researchers conducted a retrospective survey in 200 consecutive outpatients with Crohn's disease.
Endogenous creatinine clearance was estimated from serum creatinine with the Cockroft and Gault formula.
The first endogenous creatinine clearance was chosen close to the start of 5-aminosalicylates.
The second was the most recent endogenous creatinine clearance available.
The research team reported that in 153 patients, of which 59 were men and 94 were women, sufficient data were available for analysis.
The team noted that the interval between endogenous creatinine clearance was 11 years, with a mean exposure to 5-aminosalicylates of 9 years.
|The mean decline in endogenous creatinine clearance was 0.3 mL/min/yr with Crohn's |
|Inflammatory Bowel Diseases|
The cumulative dose of 5-aminosalicylates amounted to 9 kg.
The researchers observed that the endogenous creatinine clearance declined from 100 to 92 mL/min, at a rate of 0.3 mL/min/yr.
In a multiple linear regression model, duration of the interval was a significant predictor for change in endogenous creatinine clearance.
However, the team noted that cumulative dose of 5-aminosalicylates was not predictive of change in endogenous creatinine clearance.
No interstitial nephritis was reported.
The team found that, in the 8 patients with the largest decline in endogenous creatinine clearance, comorbidity causing renal function impairment was present.
Dr de Jong's team concluded, “The mean decline in endogenous creatinine clearance of 0.3 mL/min/yr in patients with Crohn's disease does not exceed the decline expected from physiologic aging.”
“Furthermore, the cumulative dose of 5-aminosalicylates was not a predictor for change in renal function.”
“However, as interstitial nephritis caused by 5-aminosalicylates may rarely occur, we still advocate measurements of serum creatinine before and during treatment.”