Renal insufficiency in patients with inflammatory bowel disease: An often underestimated complication

Abstract

Inflammatory bowel disease (IBD), which primarily encompasses Crohn’s disease and ulcerative colitis, comprises a group of chronic inflammatory disorders of the gastrointestinal tract characterized by a relapsing course, systemic manifestations, and extraintestinal complications that may significantly affect patients’ quality of life and prognosis. Although clinical attention has traditionally focused on controlling intestinal inflammation, renal abnormalities are increasingly recognized as relevant extraintestinal manifestations, the timely identification of which represents a challenge for gastroenterologists, nephrologists, and primary care physicians. Renal insufficiency in patients with IBD is a multifactorial clinical condition. It may present as acute kidney injury (AKI), generally associated with dehydration, electrolyte disturbances, infections, or adverse effects of pharmacological treatment, or progress to chronic kidney disease (CKD) as a consequence of inflammatory, immunological, metabolic, and obstructive mechanisms. The heterogeneity of these abnormalities, together with their frequently subclinical presentation, contributes to delayed diagnosis and increases the risk of irreversible deterioration in renal function.