[en] BACKGROUND AND AIMS: Patients with inflammatory bowel diseases (IBD) are exposed to drug-related nephrotoxicity and kidney-related extra-intestinal manifestations (EIMs). Patients should be monitored but guidance is lacking in current international recommendations. The objective of the Kidney Function Monitoring in Inflammatory Bowel Disease (MONITORED) initiative was to achieve an expert consensus about monitoring kidney function in IBD.
METHODS: A literature review was first conducted. Then, an expert consensus meeting, involving 28 attendees representing French-speaking gastroenterologists and nephrologists, was held as part of an academic initiative on May 28, 2021. An anonymous Delphi process was used to discuss and vote on statements. Agreement was defined as at least 75% of participants voting for any one statement.
RESULTS: Experts reached consensus on 11 criteria for referral to the nephrologist. Concerning kidney function monitoring, participants unanimously validated the use of serum creatinine with estimation of the glomerular filtration rate via the MDRD or CKD-EPI equations. A blood ionogram and a urine sample with measurement of a protein-to-creatinine ratio were also broadly agreed validated. Experts recommended performing this monitoring at IBD diagnosis, prior introducing a new treatment, and annually for EIMs screening and evaluation of treatment tolerance. An evaluation 3 months after starting mesalamine and then every 6 months was felt necessary, while for biologics an annually monitoring was deemed sufficient.
CONCLUSION: The MONITORED consensus proposed guidelines on how to monitor kidney function in IBD. These recommendations should be considered in clinical practice to preserve kidney function and ensure the best approach to our patients.
Disciplines :
Urology & nephrology
Author, co-author :
Guillo, Lucas ; Department of Gastroenterology, University Hospital of Marseille Nord, University of Aix-Marseille, Marseille, France. Electronic address: lucas.guillo690@gmail.com
DELANAYE, Pierre ; Centre Hospitalier Universitaire de Liège - CHU > > Service de néphrologie
Flamant, Martin; Physiologie-Explorations Fonctionnelles, FHU APOLLO, Assistance Publique Hôpitaux de Paris, Hôpital Bichat-Claude Bernard, Université de Paris, CRI, INSERM F-75018, Paris, France
Figueres, Lucile; Université de Nantes, Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Service de néphrologie-immunologie clinique, CHU de Nantes, France
Karam, Sabine; Division of Nephrology and Hypertension, Saint-George Hospital University Medical Center, Beirut, Lebanon
Lemoine, Sandrine; Service de Néphrologie, dialyse, hypertension et exploration fonctionnelle rénale, Hôpital Edouard Herriot, Lyon, France
Benezech, Alban; Departement of Gastroenterology, Henri Duffaut Hospital, Avignon, France
Pelletier, Anne-Laure; Departement of Gastroenterology, Bichat Hospital, APHP, Paris, France
Amiot, Aurélien; Department of Gastroenterology, Groupe Hospitalier Henri Mondor-Albert Chennevier, APHP, EC2M3-EA7375, University of Paris Est Créteil, Créteil, France
Caron, Bénédicte; Department of Gastroenterology and Inserm NGERE U1256, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France
Stefanescu, Carmen; Department of Gastroenterology, IBD unit, Beaujon Hospital, APHP, Clichy, France
Boschetti, Gilles; Department of Gastroenterology, Hospices Civils de Lyon, Lyon-Sud Hospital, Pierre Bénite, and INSERM U1111 - CIRI, Lyon, France
Bouguen, Guillaume; Department of Gastroenterology, Centre Hospitalier Universitaire Pontchaillou, Rennes, France
Rahier, Jean-François; Department of Gastroenterology, CHU UCL Namur, Yvoir, Belgium
Gornet, Jean-Marc; Department of Gastroenterology, Saint-Louis Hospital, APHP, Paris, France
Hugot, Jean-Pierre; Department of Pediatric Gastroenterology, Hôpital Universitaire Robert Debré, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris, France
Bonnet, Joëlle; Department of Gastroenterology, Saint-Louis Hospital, APHP, Paris, France
Vuitton, Lucine; Department of Gastroenterology, Besancon University Hospital, Besancon, France
Nachury, Maria; Univ, Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
Vidon, Mathias; Department of gastroenterology, CHI Créteil, Créteil, France
Uzzan, Mathieu; Department of Gastroenterology, IBD unit, Beaujon Hospital, APHP, Clichy, France
Serrero, Mélanie; Department of Gastroenterology, University Hospital of Marseille Nord, University of Aix-Marseille, Marseille, France
Dib, Nina; Hepato-Gastroenterology Department, Angers University Hospital, Angers, France, HIFIH Laboratory, UPRES 3859, SFR 4208, Angers University, Angers, France
Seksik, Philippe; Department of Gastroenterology, Centre de recherche Saint-Antoine, Sorbonne Université, APHP, Hôpital Saint-Antoine, Paris, France
Hebuterne, Xavier; Gastroenterology and Clinical Nutrition, CHU of Nice, University Côte d'Azur, Nice, France
Bertocchio, Jean-Philippe; Nephrology Department, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
Mariat, Christophe; Service de Néphrologie, Dialyse, Transplantation Rénale, Hôpital Nord, CHU de Saint-Etienne, EA 3065, Université Jean MONNET, Saint-Etienne, France
Peyrin-Biroulet, Laurent; Department of Gastroenterology and Inserm NGERE U1256, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France
No funding. Authors are grateful to the Pr Maryvonne Hourmant, the SFNDT (Société Francophone de Néphrologie Dialyse et Transplantation) and the GETAID (Groupe d'etude Thérapeutique des Affections Inflammatoires du Tube Digestif) for their support in the MONITORED initiative. The data underlying this article are available in the article and in its online supplementary material. LG and LPB participated in the study concept and design, acquisition of data, analysis and interpretation of data, along with drafting of the manuscript. All authors participated in the consensus meeting on 28 May 2021, critically reviewed the manuscript for important intellectual content and approved the final version of the manuscript.L Guillo declares consulting fees for Abbvie. A Amiot declares counseling, boards, lecture, transports or fees from Abbvie, Hospira, Takeda, Gilead, Biocodex, Janssen, Ferring and MSD. B Caron has received lecture and/or consulting fees from Abbvie, Amgen, Celltrion, Janssen, Takeda. G Boschetti has served as a speaker and advisory board member for Abbvie, Janssen, Ferring, Norgine, Tillotts, Pfizer, Celltrion, Takeda, Amgen, Sandoz. G Bouguen has received lecture fees from Abbvie, Ferring, MSD, Takeda, Otsuka, Amgen, Biogen, Celtrion, Janssen, Tillots and Pfizer and consultant fees from Takeda, Janssen, Mylan, Vifor Pharma and Gilead. JM Gornet has received personal fees from Amgen, Janssen Cilag, Sanofi, Takeda, Roche and Tillots Pharma. J Bonnet has received consulting fees for Amgen. L Vuitton has received lecture fees from Abbvie, MSD, Takeda, Ferring, Janssen and Pfizer, and research grants from MSD, Takeda and Pfizer. M Nachury received board membership, consultancy, or lecture fees from Abbvie, Adacyte, Amgen, Arena, CTMA, Celltrion, Ferring, Fresenius-Kabi, Janssen, Mayoli-Spindler, MSD, Pfizer, Takeda. M Uzzan has served as a speaker for Janssen and Abbvie. M Serrero declares lecture and consulting fees for Abbvie, Celltrion, Ferring, Janssen, MSD, Takeda and Tillotts. L Peyrin-Biroulet has served as a speaker, consultant and advisory board member for Merck, Abbvie, Janssen, Genentech, Mitsubishi, Ferring, Norgine, Tillotts, Vifor, Hospira/Pfizer, Celltrion, Takeda, Biogaran, Boerhinger-Ingelheim, Lilly, HAC- Pharma, Index Pharmaceuticals, Amgen, Sandoz, For- ward Pharma GmbH, Celgene, Biogen, Lycera, Samsung Bioepis, Theravance.
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