Abstract
Background
The kidney function monitoring is recommended in routine practice to detect 5-aminosalicylic
acid (5-ASA) related nephrotoxicity, although is not standardized. The optimal monitoring
is unknown, especially the best timing and which tests to perform. We summarized why,
how, and when to perform the monitoring for patients treated with 5-ASA and provided
an overview of the current guidelines on this topic.
Method
Relevant studies on this topic were searched in PubMed, Embase, and Web of Science
databases from July to August 2020.
Results
Serum creatinine, the estimated glomerular filtration rate, and 24-h proteinuria are
the 3 main tests used for the monitoring in daily practice. Regarding the timing,
several monitoring strategies have been proposed and guidelines are available too,
but they provide conflicting information. To date, there is no medical evidence-based
that one strategy is better than another. Comorbidities, chronic renal disease, use
of nephrotoxic drugs or concomitant steroid therapy also impact the nephrotoxicity
risk. Based on the literature review we proposed a kidney function monitoring strategy
to guide physicians in clinical practice.
Conclusion
A baseline assessment should be performed in all patients treated with 5-ASA. The
monitoring should be carried out according to the other nephrotoxic factors. A tight
monitoring may reduce morbidity and mortality of drug nephrotoxicity.
Keywords
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Article info
Publication history
Published online: February 06, 2021
Accepted:
January 14,
2021
Received:
October 16,
2020
Identification
Copyright
© 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
