S0659 The Prevalence of Chronic Kidney Disease Is Increased in Inflammatory Bowel Disease, but Decreased After Anti-TNF Treatment: A Population-Based Study

Abstract

INTRODUCTION: Patients with inflammatory bowel disease (IBD) may be at an increased risk of chronic kidney disease (CKD) due to autoimmune-mediated glomerulopathy. Additionally, traditional IBD therapies are known to be nephrotoxic. The effect of Anti-tumor necrosis factor (anti-TNF) on renal function remains unclear especially in IBD. We sought to investigate the prevalence of CKD in IBD patients treated with and without anti-TNF. METHODS: We used a commercial database (Explorys Inc, Cleveland, OH) which includes electronic health record data from 26 major integrated US healthcare systems. Based on Systematized Nomenclature Of Medicine—Clinical Terms (SNOMED-CT), we identified all patients (age >18 years) who were diagnosed with either CD or UC between 2015 and 2020 who were treated with any type of anti-TNFs. We investigated the prevalence of CKD in IBD patients compared to patients with no IBD. Also, we compared the prevalence between IBD patients with and without anti-TNF therapy. RESULTS: Of the 32, 411,600 individuals in the database from 2015 to present, we identified 139,710 (0.43%) patients with CD and 114,770 (0.35%) patients with UC, of whom 24,160 (17.3%) and 8,080 (7%) patients received anti-TNFs, respectively. The prevalence of CKD was 8.3% and 8.7% for CD and UC, respectively, compared to 3.6% in individuals without IBD, P < 0.001 to all. The prevalence of CKD was significantly lower in anti-TNF treated CD patients (4.6%) compared to those who did not receive anti-TNF (9.1%). Similarly, anti-TNF treated UC patients were significantly less likely to have CKD (3.7%) compared to UC patients who did not receive anti-TNF therapy (9%), (P < 0.001 to all). CONCLUSION: This is the largest individual study investigating prevalence of CKD in patients with IBD with and without anti-TNF therapy. We found that IBD patients who were treated with anti-TNF were significantly less likely to have CKD when compared to IBD patients who were never treated with anti-TNF.Figure 1.: The prevalence of Chronic Kidney Disease in patients with Inflammatory Bowel Disease with and without Anti-TNF therapy.Table 1.: Type of Anti-TNF therapy used in inflammatory bowel disease patients with Chronic Kidney Disease.