B0413 - Epidemiology of Glomerulonephritis as an Extraintestinal Manifestation of Inflammatory Bowel Disease: A Large Population-Based Study

Monday, October 24, 2022

10:00 AM – 12:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Akash T. Khurana, MD

University Hospitals/CMC
Cleveland, OH

Akash T. Khurana, MD¹, Syed Ahmad Adil, MD¹, Mohammed Z. Sheriff, MD², Gregory Cooper, MD²
¹University Hospitals/CMC, Cleveland, OH; ²University Hospitals Digestive Health Institute, Cleveland, OH

Introduction: Inflammatory bowel disease (IBD), including both Crohn’s disease (CD) and Ulcerative colitis (UC), are known to cause many extraintestinal manifestations. There is limited data describing the association between IBD and renal manifestations. This study provides epidemiologic data to further understand the association between IBD and glomerulonephritis (GN).

Methods: The aim of this study was to investigate if IBD is associated with GN. Data was collected from a commercial database (Explorys Inc, Cleveland, OH), an aggregate of EHR data from 27 integrated healthcare systems in the US between 1/2017-1/2022. We identified patients with CD and UC based on Systemized Nomenclature of Medicine – Clinical Terms. We compared the prevalence of GN at least 30 days post-CD or post-UC diagnosis to a control cohort without CD or UC. We excluded patients with a diagnostic predisposition for development of GN (Table 1).

Results: Of the 34,063,760 patients, we identified 149,630 cases of CD and 127,300 cases of UC. There were 310 and 260 cases of glomerulonephritis at least 30 days after diagnosis of CD and UC, respectively. Overall prevalence of glomerulonephritis for CD and UC was 207/100000 persons and 203/100000 persons, whereas for the cohort without CD and UC was 72/100000 persons and 72/100000 persons. Prevalence ratios (PR) of developing glomerulonephritis after at least 30 days of a CD and UC diagnosis were 2.88 (95% CI, 2.57-3.22, p< 0.001) and 2.83 (95% CI, 2.51-3.20, p< 0.001), respectively. Table 2 shows prevalence and PR in CD and UC sub-categorized by demographics. Membranous GN was the most prevalent (CD 90, UC 90), followed by proliferative (CD 50, UC 50), mesangiocapillary (CD 30, UC20 ), diffuse (CD 10, UC 0) and focal membranoproliferative (CD 10, UC 10).

Discussion: In this large population-based study, glomerulonephritis was significantly more prevalent in patients with both CD and UC compared to those without IBD. Further studies are needed to understand the pathophysiological mechanism underlying renal involvement.

Figure: Table 2. Prevalence and prevalence ratios of glomerulonephritis after at least 30 days post-CD and post-UC diagnosis.

Excluded diagnoses

Systemic lupus erythematosus

Goodpasture's syndrome

Hereditary nephritis

Post-infectious GN

Granulomatosis with polyangiitis

Allergic grandulomatosis angiitis

Alport syndrome

Human immunodeficiency virus

Hepatitic B virus

Hepatitis C virus

Nephrotic syndrome with membranoproliferative glomerulonephritis

Primary pauci-immune necrotizing and crescentic glomerulonephritis

Berger's immunoglobulin A or immunoglobulin G nephropathy

Table: Table 1. Diagnoses excluded prior to analysis

Disclosures:

Akash Khurana indicated no relevant financial relationships.

Syed Ahmad Adil indicated no relevant financial relationships.

Mohammed Sheriff indicated no relevant financial relationships.

Gregory Cooper indicated no relevant financial relationships.

Akash T. Khurana, MD¹, Syed Ahmad Adil, MD¹, Mohammed Z. Sheriff, MD², Gregory Cooper, MD². B0413 - Epidemiology of Glomerulonephritis as an Extraintestinal Manifestation of Inflammatory Bowel Disease: A Large Population-Based Study, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.