Colectomy Associated With Risk of Kidney Failure

A nationwide Swedish cohort study published in Clinical Gastroenterology and Hepatology, investigated the association between colectomy and the risk of acute kidney injury (AKI) and kidney failure in individuals with inflammatory bowel disease (IBD). The study included 82,051 individuals with biopsy-proven IBD diagnosed between 1965 and 2017, with follow-up through 2019. The primary outcomes were the development of AKI and kidney failure, defined as either end-stage kidney disease or death from chronic kidney disease. Cox proportional hazard models were used to assess the impact of colectomy, adjusting for factors such as demographics, education, and comorbidities.

Over a median follow-up of 14 years, 16,479 individuals underwent colectomy, and 2556 AKI and 1146 kidney failure events occurred. Colectomy was associated with a significantly increased risk of both AKI (adjusted hazard ratio [aHR], 2.37; 95% confidence interval [CI], 2.17–2.58) and kidney failure (aHR, 1.54; 95% CI, 1.34–1.76). Total colectomy and colectomy with prolonged stoma were associated with higher risks of kidney complications compared with partial colectomy or temporary stoma. Patients with ulcerative colitis appeared to have a particularly elevated risk.

The findings suggest that individuals with IBD, especially those undergoing total colectomy or with a prolonged stoma, are at increased risk for kidney complications.

Reference
Yang Y, Ludvigsson JF, Forss A, et al. Risk of kidney failure in patients with inflammatory bowel disease undergoing colectomy: a nationwide cohort study. Clin Gastroenterol Hepatol. Published online May 20, 2024. doi:10.1016/j.cgh.2024.05.010