de Sire Roberto, La Mantia Alessia, Bonacci Livio, Testa Anna, Guarino Alessia Dalila, Rispo Antonio, Nardone Olga Maria, Castiglione Fabiana
IBD Unit, Department of Clinical Medicine and Surgery, University Federico II, 80126 Naples, Italy.
Endoscopy Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy.
Life (Basel). 2024 Nov 25;14(12):1541. doi: 10.3390/life14121541.
Inflammatory bowel disease (IBD) can extend beyond the gastrointestinal tract, affecting extraintestinal organs and significantly increasing morbidity and mortality. Despite early studies revealing kidney involvement in nearly a quarter of patients with IBD, renal manifestations have been notably overlooked. Among these manifestations, nephrolithiasis, obstructive uropathy, and fistula formation between the bowel and urinary tract are the most reported occurrences. Additionally, renal parenchymal involvement in IBD, including glomerulonephritis (GN), tubulointerstitial nephritis, and amyloidosis, has been documented. GN is particularly noteworthy, as a significant proportion of patients progress to end-stage kidney disease (ESKD). Although GN has long been recognized as a potential extraintestinal manifestation (EIM) of IBD, it has often been dismissed as an anecdotal association. Recently, several studies highlighted the clinical correlation between GN and IBD, suggesting a pathogenic interplay involving gut inflammation, dysbiosis, and intrinsic glomerular processes. Thus, our objective is to elucidate the basis of IBD-related nephropathies, with a specific focus on IgA nephropathy (IgAN) and the gut-kidney axis.
炎症性肠病（IBD）可累及胃肠道以外的部位，影响肠外器官，并显著增加发病率和死亡率。尽管早期研究显示近四分之一的IBD患者存在肾脏受累情况，但肾脏表现一直被显著忽视。在这些表现中，肾结石、梗阻性尿路病以及肠道与泌尿道之间的瘘管形成是最常报道的情况。此外，IBD累及肾实质，包括肾小球肾炎（GN）、肾小管间质性肾炎和淀粉样变性也有文献记载。GN尤为值得关注，因为相当一部分患者会进展为终末期肾病（ESKD）。尽管GN长期以来一直被认为是IBD的一种潜在肠外表现（EIM），但它常常被视为一种偶然关联而被忽视。最近，多项研究强调了GN与IBD之间的临床相关性，提示存在涉及肠道炎症、菌群失调和肾小球内在过程的致病相互作用。因此，我们的目标是阐明IBD相关肾病的基础，特别关注IgA肾病（IgAN）和肠-肾轴。
