PDF(Pubmed)
Abstract：
Patients with inflammatory bowel disease (IBD) are prone to develop kidney injury. Renal involvement in IBD patients is usually diagnosed by the measurement of serum creatinine and the estimation of the glomerular filtration rate. We describe a patient with IBD who presented with large fluctuations in his serum creatinine level (~3.0-fold) without significant histologic abnormalities and with a normal cystatin C level. This appears to be related to a high-protein diet and intermittent fasting. Even though the impact of a high-protein diet on mild elevations of the serum creatinine level has been described, large fluctuations in serum creatinine from diet alone, as seen in this case, have never been reported, raising the question about the potential contribution of inflamed bowel on gut absorption or metabolism of creatinine. This case highlights the importance of a detailed history, including the dietary habits, when encountering a patient with increased serum creatinine level, and careful interpretation of serum creatinine in a patient with a creatinine high-protein diet or underlying IBD.
摘要：
炎症性肠病(IBD)患者容易发生肾损伤。IBD患者的肾脏受累通常通过测量血清肌酐和估计肾小球滤过率来诊断。我们描述了一名IBD患者，其血清肌酐水平波动较大（〜3.0倍），无明显的组织学异常，胱抑素C水平正常。这似乎与高蛋白饮食和间歇性禁食有关。尽管已经描述了高蛋白饮食对血清肌酐水平轻度升高的影响，单独饮食中血清肌酐的大幅波动，正如在这种情况下看到的，从未被报道过，提出了关于肠道炎症对肠道吸收或肌酐代谢的潜在贡献的问题。这个案例突出了详细历史的重要性，包括饮食习惯，当遇到血清肌酐水平升高的患者时，以及对肌酐高蛋白饮食或基础IBD患者的血清肌酐的仔细解释。
