5-Aminosalicylates and renal function monitoring in inflammatory bowel disease: a nationwide survey.

BACKGROUND AND AIM

5-Aminosalicylates (ASA) are widely used in inflammatory bowel disease (IBD). Nephrotoxicity has been described in some IBD patients treated with 5-ASA. Whether physicians managing these patients are monitoring renal function in daily practice is unknown. The aims of this paper were to investigate how private gastroenterologists monitor renal function and manage renal failure in IBD patients treated with oral 5-ASA therapy.

METHODS

This was a web-based cross sectional national survey which was conducted among private gastroenterologists.

RESULTS

A total of 249 practitioners completed the survey. Eighty two percent (n=205) of responders declared that they always monitor renal function. The respondents monitored twice a year Glomerular Filtration Rate (eGFR) using Modification of Diet in Renal Disease (MDRD) [90% (n=225)] and Creatinine Clearance (CCr) using a 24-hour urine collection [51% (n=126)]. Blood electrolytes, 24-hour urinary protein rate and dipsticks are performed by 41%, 39% and 22% of practitioners, respectively. Before oral 5-ASA initiation, 59% (n=148) of respondents screen for renal failure. In case of elevated serum creatinine, a nephrologist's opinion is asked by 80% (n=200) of responders and by 76% (n=189) of respondents before treatment initiation.

CONCLUSIONS

Most gastroenterologists are monitoring renal function once or twice a year in IBD patients on 5-ASA. Less than two thirds of them screen for renal failure before treatment initiation. MDRD is mainly used, but a wide range of parameters is evaluated.