Knowledge of 5-aminosalicylic acid nephrotoxicity and adherence to kidney function monitoring of patients with inflammatory bowel disease

Eur J Gastroenterol Hepatol. 2021 Sep 1;33(9):1148-1152.doi: 10.1097/MEG.0000000000002008.

Lucie Weislinger 1, Lucas Guillo 1 2, Ferdinando D'Amico 1 3, Silvio Danese 3 4, Hamza Achit 5, Carole Ayav 5, Francis Guillemin 5, Laurent Peyrin-Biroulet 1, Luc Frimat 6


Author information

  • 1Department of Gastroenterology and Inserm NGERE U1256, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy.
  • 2Department of Gastroenterology, University Hospital of Marseille Nord, University of Aix-Marseille, Marseille, France.
  • 3Department of Biomedical Sciences, Humanitas University, Pieve Emanuele.
  • 4Department of Gastroenterology, IBD Center, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy.
  • 5Inserm, CIC-1433 Clinical Epidemiology, University Hospital of Nancy, Université de Lorraine.
  • 6Department of Nephrology and Inserm CIC-EC CIE6, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France.


Background and aim: 5-Aminosalicylic acid (5-ASA) nephrotoxicity is a rare and idiosyncratic condition in patients with inflammatory bowel disease (IBD), which may lead to end-stage kidney failure. Kidney function monitoring is recommended in clinical practice to prevent this complication. However, no data is available regarding the knowledge and adherence of patients with IBD to this monitoring.

Methods: As a part of routine practice, patients with IBD under treatment or previously treated with 5-ASA were systematically interviewed about knowledge of 5-ASA nephrotoxicity and adherence to kidney function monitoring. We reported here the experience among the first 103 consecutive patients seen in a French referral center.

Results: A total of 103 patients (93.2% ulcerative colitis, 5.8% Crohn's disease, and 1% unclassified colitis) were analyzed. Among them, 70% were informed about the need for kidney function monitoring, and in most cases, information was provided by their gastroenterologist (94.4%). The adherence rate to monitoring was very high (84.7%). Monitoring consisted of serum creatinine and estimated glomerular filtration rate in most cases (97.2%), while 24-h proteinuria was less frequently used (69.4%). These tests were performed twice or ≥3 times per year by 44.4 and 41.7% of patients, respectively. One case of isolated elevation of proteinuria related to 5-ASA treatment was observed.

Conclusion: We reported for the first time that patients with IBD are well informed and adherent to kidney function monitoring of treatment with 5-ASA. The monitoring performed by their treating physician was generally in accordance with current recommendations.

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