Kidney Disease Outcomes in Patients with Inflammatory Bowel Disease
Bibliographic record
Abstract
Background: Patients with inflammatory bowel diseases (IBD), Crohn’s disease (CD) and ulcerative colitis (UC) may have extra-intestinal manifestations (EIM). The prevalence of histologic patterns of kidney disease seen in IBD patients is known, but clinical characteristics and long-term kidney outcomes remain ill-defined. Methods: We performed a multi-center, retrospective, study of IBD patients who had a kidney biopsy across 3 centers. Inclusion criteria were: (i) IBD diagnosis based on clinical/histological characteristics and (ii) kidney biopsy with pathology report available. Baseline clinical data were analyzed for the whole cohort while outcomes were evaluated in those with available follow-up. Between groups, comparisons for continuous variables were made using Wilcoxon two-sample test and Fisher’s exact test for categorical values. Results: The frequency of various glomerular (GN), tubulointerstitial (TIN), and vascular (VD) processes are listed in Table 1. Patients with VD were older compared to other groups. At presentation, proteinuria was higher in patients with GN compared to those with TIN [2.13 (0.84, 4.07) vs. 0.30 (0.25, 1.25) p<0.05] and kidney function was worse in those with TIN compared to GN (3.10 [1.98, 4.50] vs. 2.10 [1.20, 3.11], p=0.05]). TIN occurred in 3 treatment naïve patients. In median follow-up of >3 years, 6 of 35 (17%) GN patients, 1 of 8 (12.5%) TIN, and 2 of 4 (50%) VD patients developed ESKD. Table 1 - Frequency of various kidney diseases in patients with IBD CD+UC+IBD@ n=96 CD n=56 UC n=36 IgAN FSGS Amyloidosis-MGRS ANCA-vasculitis Other GN 18 10 8 8 12 11 6 5 3 5 6 3 3 5 7 TIN 14 8 5 VD 12 8 4 Other 9 6 3 @IBD - 4 patients had IBD without distinctive features of CD/UC -- 1 each had IgAN, FSGS, TIN, ATN4 patients in CD and 1 in UC group had only ATN; MGRS=monoclonal gammopathy of renal significance, ANCA=Anti-neutrophil cytoplasmic antibody; Others: neoplasm, non-specific interstitial fibrosis Conclusions: Patients with IBD may have varying forms of CKD including GN, and routine monitoring of kidney function is essential for early diagnosis and treatment. TIN may occur as an EIM independent of sulfasalzine therapy. Future studies are required to understand plausible shared immunopathogenesis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".