Prevalence of Renal Stones Among Patients With Inflammatory Bowel Disease in Saudi Arabia.

Mahmoud Mosli,Ghidah Z Altabsh,Razan N Alturkestani,Rafeef A Bahafzalla,Omar I Saadah,Sondos S Hussein,Abdulrahman M Alzahrani,Tala A Gazzaz,Rahaf M Slaghour,Abdullah Kashgary,Sarah B Aljadani

doi:10.7759/cureus.15787

Abstract

Introduction: Crohn’s disease (CD) and ulcerative colitis (UC) are chronic inflammatory bowel diseases (IBD) that affect the gastrointestinal tract with no identified etiology. IBD has been associated with several extraintestinal manifestations (EIMs), including renal involvement such as renal stones (nephrolithiasis), resulting in significant morbidity. This study aims to estimate the prevalence of renal stones among IBD patients in Saudi Arabia.Methods: This is a retrospective study conducted at King Abdulaziz University Hospital between January 2019 and December 2020. All IBD patients with abdominal imaging studies were included in the study regardless of their age. Data were collected from the electronic hospital information system and analyzed.Results: A total of 363 IBD patients fulfilled the study inclusion criteria. Nephrolithiasis was detected radiologically in 3.6% of the cohort (5.1% of UC and 2.7% of CD patients). Patients with renal stones are older (P=0.002) and more likely to be diabetic (P=0.047), have microscopic hematuria (P<0.001), and proteinuria (P=0.002). Binary logistic regression analysis showed that older age at diagnosis (P=0.003) and microscopic hematuria (P=0.02) are independent predictors for renal stones.Conclusion: The study reported that 3.6% of Saudi IBD patients had renal stones, with a higher prevalence of renal stones formation among UC patients than Crohn's. Older age at diagnosis and the presence of microscopic hematuria may predict the development of renal stones. Future studies should be conducted in a prospective manner at multiple centers across Saudi Arabia for further investigation.

Highlights

Crohn’s disease (CD) and ulcerative colitis (UC) are chronic inflammatory bowel diseases (IBD) that affect the gastrointestinal tract with no identified etiology
The current study estimated that 3.6% of IBD patients have renal stones, which is lower than the prevalence rate reported in the United States of 12-28% [12]
Our results showed a higher prevalence of renal stone formation among UC patients compared to CD (5.1% vs. 2.7%)

Summary

Introduction

Crohn’s disease (CD) and ulcerative colitis (UC) are chronic inflammatory bowel diseases (IBD) that affect the gastrointestinal tract with no identified etiology. IBD has been associated with several extraintestinal manifestations (EIMs), including renal involvement such as renal stones (nephrolithiasis), resulting in significant morbidity. This study aims to estimate the prevalence of renal stones among IBD patients in Saudi Arabia. Saudi Arabia showed a similar rise in IBD incidence, with a higher CD incidence than UC [3,4]. The clinical manifestations of IBD are consequences of ongoing inflammation, which is responsible for the progressive damage of the gastrointestinal tract. IBD has several extraintestinal manifestations (EIMs) involving the musculoskeletal system (arthritis and ankylosing spondylitis), skin (erythema nodosum, and pyoderma gangrenosum), and the eyes (Iritis and episcleritis). Among the EIMs of IBD, renal stones (nephrolithiasis) may develop in some IBD patients and result in significant morbidity [6]. Renal involvement in IBD patients may lead to the development of renal insufficiency, which occurs in approximately 15.9% of patients [9]

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