Inflammatory Bowel Diseases Clinical Trial
Official title:
Urinary Nephrin and Alpha One Microglobulin as Early Renal Injury Biomarkers in Patients With Inflammatory Bowel Disease
The study aims to early detection of renal injury in patients diagnosed to have inflammatory bowel disease with normal kidney function test focusing on glomerular filtration barrier injury and tubular injury and it's relation to disease activity so precautions could be taken properly to prevent further renal injury later on .
Inflammatory bowel disease (IBD) is a chronic and relapsing inflammatory condition of the
gastrointestinal tract. Crohn's disease and ulcerative colitis are the two principal types of
IBD. The prevalence of IBD has been increasing worldwide . Extraintestinal manifestations of
IBD are common, occurring in 6% to 47% of patients involving nearly every organ system .
Renal and urinary system involvement are common in IBD patients with incidence varying from
4% to 23% and is greater in patients with more severe and long-standing disease. Apart from
secondary complications, such as nephrolithiasis, hydronephrosis and amyloidosis, other
disorders have also been reported. Membranous glomerulonephritis, rapidly progressive
glomerulonephritis, mesangiocapillary glomerulonephritis, IgA nephropathy, thin basement
membrane disease and kidney granuloma found to be connected with IBD. In addition,
non-specific morphological changes in the glomeruli of patients with IBD, like podocyte
effacement and mesangial deposition of immunoglobulin and complement have been well
documented. Cases of interstitial nephritis reported to be attributed to the nephrotoxic
effect of aminosalicylates which used in IBD treatment.
Alpha one microglobulin is a relatively small protein that undergoes glomerular filtration
followed by reabsorption and catabolism in the proximal tubules. Increased urinary
α1-microglobulin concentration therefore provides an index of proximal tubule dysfunction .
Glomerular filtration barrier related protein changes have not been closely investigated in
IBD patients . Nephrin is podocyte-associated protein that play key roles in maintaining the
structural and functional integrity of the kidney's filtration barrier. The shedding of
nephrin reflects compromisation of podocytes' functional and structural integrity.
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