الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Inflammatory bowel disease (IBD) is a group of chronic idiopathic immune mediated inflammatory intestinal conditions. The main categories are Crohn’s disease (CD) and Ulcerative colitis (UC); they both have overlapping, distinct clinical and pathological features and characterized by relapsing and remitting episodes of gastrointestinal inflammation. Approximately 25% of patients with IBD are diagnosed during their childhood or adolescence. Presenting symptoms often include rectal bleeding, anemia, diarrhea, and weight loss. They may be associated with other disorders, including arthritis, ankylosing spondylitis, cholangitis, erythema nodosum, iritis and uveitis. Crohn’s disease can affect any part of the gastrointestinal tract, where Ulcerative colitis is characterized by inflammation mostly confined to the large intestine. Microscopically, Crohn’s disease affects the entire wall of the intestine, where Ulcerative colitis is restricted to the epithelial mucosal lining of the colon starting at the anal canal and extending retrograde ascending, without any “skip areas” as in Crohn’s disease. The prevalence of extra intestinal manifestations (EIMs) in IBD varies from 6% to 46%. The etiology of them remains unclear. There are theories based on an immunological response. EIMs can involve almost every organ system. EIMs may originate from the same pathophysiological mechanism of IBD, or as secondary complications of IBD, or autoimmune diseases susceptibility. The most frequently involved organs are the joints, eyes, skin, liver and biliary tract. Renal involvement in IBD has been considered as EIMs of IBD and has been described in both CD and UC. The most frequent renal involvement in patients with IBD are nephrolithiasis, tubulointerstitial nephritis, amyloidosis, glomerulonephritis, renal carcinoma and renal failure which may ultimately require hemodialysis. Consequently, this cross-sectional study was conducted and aimed to study the epidemiology of renal insufficiency in IBD patients admitted to Tanta University Hospitals from November 2021 till October 2022. During this study, 100 IBD patients were enrolled. All patients had their serum creatinine and GFR measured using MDRD equation at admission. In our study, Crohn’s disease was observed in 8% of cases while ulcerative colitis was observed in 92% of them. There were no significant differences between UC and CD regarding sociodemographic characteristics, personal data of the studied patients, associated medical comorbidities, mediations used, time elapsed since diagnosis, severity, local extension of the disease and extra intestinal manifestations. On the other hand, IBD-related surgeries were significantly higher in CD (50% Vs 10.87%). As regard renal assessment, mean serum creatinine level was 0.96 ± 0.21 and eGFR level was 79.09± 20.56. Renal impairment was found in only 16% of cases and there were no significant differences between UC and CD regarding renal evaluation among the studied patients. Finally, we reported that renal impairment in IBD patients was significantly higher with increasing age, the co-existence of DM, hyperlipidemia and with the use of antibiotic, NSAIDs, acetaminophen, azathioprine. Also, with IBD related surgeries and EIMs as arthritis and uveitis.