The Effect of 5-Aminosalicylic Acid on Renal Function in Patients with Inflammatory Bowel Disease

Kim, Kyeong Ok; Jang, Byung Ik; Kim, Tae Nyeun; Lee, Si Hyung

Abstract

BACKGROUND/AIMS: An increasing number of case reports indicate the potential nephrotoxicity of 5-aminosalicylic acid (ASA). The aim of this study was to investigate the effect of long-term use of 5-ASA on renal function in patients with inflammatory bowel disease (IBD). METHODS: The medical records of 318 patients with IBD that were treated with 5-ASA from 2001 to 2007 at Yeungnam University Hospital were reviewed. Changes in creatinine clearance (CCr), as measured by modification of diet with the renal disease study (MDRD) method, and risk factors were analyzed. RESULTS: One-hundred patients were available for analysis. The male to female ratio was 55:45 and the mean age was 35.89+/-14.1 years. Fifty-eight patients were diagnosed with Crohn's disease and the other patients were diagnosed with ulcerative colitis. The mean treatment duration with 5-ASA was 2.6+/-2.5 years and 85 patients were treated with mesalazine and eight patients were treated with sulfasalazine. The mean baseline glomerular filtration rate (GFR) was 112.9+/-25.3 mL/min. The mean CCr declined to 106.3+/-28.3 ml/min/m2 with an annual decline of 1.44 ml/min/year/m2, but there was no statistically significant change in the mean CCr. Changes in the CCr were correlated with the pretreatment CCr. CONCLUSIONS: There was no statistically significant change in serum CCr. Although 5-ASA therapy in IBD patients resulted in no meaningful effect on renal function, the annual decline was within the normal range (0.4-1 mL/min/m2). Serial follow-up of GFR has significance. A large prospective study with a longer time is needed to confirm these findings.