Microproteinuria in patients with inflammatory bowel disease: is it associated with the disease activity or the treatment with 5-aminosalicylic acid?
OBJECTIVE
To investigate whether microproteinuria in patients with inflammatory bowel disease (IBD) is associated with the disease activity or the treatment with 5-aminosalicylic acid (5-ASA).


METHODS
We prospectively studied microproteinuria in 86 consecutive patients with IBD, 61 with ulcerative colitis (UC) and 25 with Crohn's disease (CD), before as well as 2 and 6 months after their inclusion in the study. Forty-six patients received 5-ASA for a period of 28.8 months (range 1-168 mo). Microalbuminuria (mALB) and urine levels of the renal tubular proteins beta2-microglobulin (beta2mGLB) and beta-N-acetyl-D-glucosamidase (beta-NAG) as well as the creatinine clearance were determined in a 12-h overnight urine collection. Tumor necrosis factor-alpha (TNF-alpha) serum levels were also measured.


RESULTS
A total of 277 measurements (194 in UC patients and 83 in CD patients) were performed. The prevalence of abnormal microproteinuria in UC and CD patients was 12.9% and 6.0% for mALB, 22.7% and 27.7% for beta2mGLB, and 11.3% and 8.4% for beta-NAG, respectively. mALB was not associated with IBD activity. Beta2mGLB and beta-NAG urine levels were correlated to UC activity (UCAI: P<0.01; UCEI: P<0.005). mALB in UC patients and beta-NAG urine levels in CD patients were related to TNF-alpha serum levels. An association was noticed between microproteinuria and smoking habit. Treatment with 5-ASA was not correlated to the severity of microproteinuria or to the changes of creatinine clearance.


CONCLUSIONS
Microproteinuria is mainly associated with UC and its activity but not affected by 5-ASA.
Poulou
Androniki C
AC
Gastroenterology Department, Red Cross Hospital of Athens, Greece.
Goumas
Konstantinos E
KE
Dandakis
Dimitrios C
DC
Tyrmpas
Ioannis
I
Panagiotaki
Maria
M
Georgouli
Androniki
A
Soutos
Dimitrios C
DC
Archimandritis
Athanasios
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D003093:Colitis, Ulcerative / Q000150:complications / Q000188:drug therapy / Q000652:urine; D003404:Creatinine / Q000097:blood; D003424:Crohn Disease / Q000150:complications / Q000188:drug therapy / Q000652:urine; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000188:drug therapy* / Q000652:urine; D008297:Male; D019804:Mesalamine / Q000009:adverse effects*; D008875:Middle Aged; D011446:Prospective Studies; D011507:Proteinuria / Q000209:etiology*
D019804:Mesalamine; D003404:Creatinine