Abstract：
Inflammatory bowel disease [IBD] is associated with various immune-mediated disorders including spondylarthritis, pyoderma gangrenosum, primary sclerosing cholangitis, and uveitis. Chronic kidney disease [CKD] is defined by a reduction in kidney function (estimated glomerular filtration rate [eGFR] less than 60 ml/min/1.73m2] and/or damage markers that are present for at least 3 months, regardless of the aetiology. Case reports and cohort studies suggest that IBD is associated with CKD. The extent and magnitude of a potential association is unknown. A comprehensive search was conducted in EMBASE, MEDLINE, Web of Science, the Cochrane database, and SCOPUS. Two separate reviewers were involved in the process of article selection and evaluation. Odds ratios were calculated in those papers with a comparison between an IBD population and a non-IBD control population, the Mantel Haenszel test was employed, using a random effect model. The systematic review was registered in PROSPERO [RD42023381927]. A total of 54 articles was included in the systematic review. Of these, eight articles included data on prevalence of CKD in IBD patients [n = 102 230] vs healthy populations [n = 762 430]. Of these, diagnosis of CKD was based on International Classification of Diseases [ICD] codes in five studies vs on eGFR in three studies. The overall odds ratio of developing CKD in the IBD population is 1.59, [95% CI 1.31-1.93], without any difference between studies using diagnostic coding (odds ratio [OR] 1.70, 95% CI 1.33-2.19] vs diagnosis based on eGFR [OR 1.36, 95% CI 1.33-1.64]. IBD is associated with a clinically meaningful increased CKD prevalence. We provide recommendations on diagnostic evaluation, as well as suggestions for future research.
摘要：
炎症性肠病（IBD）与各种免疫介导的疾病相关，包括脊椎关节炎，坏疽性脓皮病,原发性硬化性胆管炎和葡萄膜炎。慢性肾脏疾病（CKD）的定义是肾功能降低（eGFR小于60ml/min/1.73m2）和/或存在至少三个月的损伤标志物。不管病因是什么。病例报告和队列研究表明IBD与CKD相关。潜在关联的程度和大小是未知的。在EMBASE中进行了全面搜索，MEDLINE,WebofScience,Cochrane数据库,和SCOPUS。两名独立的审稿人参与了文章选择和评估的过程。在这些论文中计算了赔率，并比较了IBD人群和非IBD对照人群，使用了MantelHaenszel测试，利用随机效应模型。系统评价在PROSPERO（RD42023381927）中注册。54篇文章被纳入系统审查。其中,八篇文章包括IBD患者CKD患病率的数据（n=102,230）与健康人群（n=762,430）。其中,在五项研究中，CKD的诊断基于ICD代码与关于eGFR的三项研究。IBD人群中发生CKD的总体比值比为1.59（95CI1.31-1.93），使用诊断编码的研究之间没有任何差异(OR1.7095CI1.33-2.19)与基于eGFR的诊断(OR1.3695CI1.33-1.64)。IBD与有临床意义的CKD患病率增加相关。我们提供有关诊断评估的建议，以及对未来研究的建议。
