Asymptomatic Urinary Anomalies, Hematuria and Proteinuria, in Patients with Inflammatory Bowel Disease. Preliminary Study SILVIA VELCIOV 1 , GH.GLUHOVSCHI 1 , I. SPOREA 2 , VIRGINIA TRANDAFIRESCU 1 , LIGIA PETRICA 1 , GH. BOZDOG 1 , CRISTINA GLUHOVSCHI 1 , F. BOB 1 , FLORICA GĂDĂLEAN 1 , ROXANA BUZAS 1 , MARIA BOBU 1 , L.VOICU 1 1 Nephrology Dept., Univ. of Medicine and Pharmacy Timişoara, Romania 2 Gastroenterology Dept., Univ. of Medicine and Pharmacy Timişoara, Romania The study assesses the presence of asymptomatic urinary anomalies in patients with inflammatory bowel disease. Asymptomatic urinary anomalies are mainly due to glomerular nephritis, they being one of the forms of its manifestation, together with chronic nephrotic and nephritic syndromes. We identified urinary anomalies in 18 patients (20%) with bowel inflammatory disease that consisted of haematuria in 8 (9%) patients, isolated proteinuria in 5 (6%) patients and haematuria associated with proteinuria in 5 (6%) patients. Asymptomatic urinary anomalies were more frequent in patients with the Crohn disease than in those with ulcerative colitis. We identified RFG under 60ml/min in 4 patients with asymptomatic urinary anomalies. It is very easy to evaluate asymptomatic urinary anomalies with dipstick. This method is also required in current practice for patients with urinary anomalies for identifying the glomerular disease that might have caused them. One must take into consideration differential diagnosis with other diseases that can manifest themselves with proteinuria or isolated proteinuria. One must also take into account the fact that urinary anomalies may also be related to administration of 5-aminosalicylates. Key words: inflammatory bowel disease; asymptomatic urinary anomalies; chronic kidney disease. Inflammatory bowel diseases are chronic system diseases. Immune mechanisms are implied in their production [1]. Extra-intestinal manifestations are present in 6–47% of the patients with bowel inflammatory disease. Extra-intestinal manifestations may also involve organs that do not belong to the gastro-intestinal tract, like the tegument, the eyes, the joints, the biliary duct and the kidney [2]. Kidney implications may be found in 4–23% patients with inflammatory bowel disease [3]. Renal manifestations in inflammatory bowel disease are various: glomerular, tubulointerstitial, kidney amyloidosis, kidney lithiasis, acute kidney injury, kidney lesions consecutive of therapies used. Chronic renal affection produces chronic kidney diseases. Glomerular nephropathies have been described both during the evolution of the Crohn disease and of ulcerative colitis [4]. Among these, the most frequently described was the nephropathy with IgA [5], but the nephropathy with Ig M, membrane nephropathies and membrane proliferative nephro- pathies have also been described. During the Crohn disease, glomerular nephrites through anti MBG antibodies and cases of nephropathy with thin base membrane have also been described [6]. Among renal manifestations, glomerular affection can be manifest during accesses of activity of the in- flammatory bowel disease [5]. Kidney amyloidosis is a rare complication appearing in approximately 1% of the patients with bowel inflammatory disease. In fact, it is well- known that kidney amyloidosis is the most severe manifestation of system amyloidosis [7]. Amyloids are most frequently deposited at glomerular level, but they can also appear at tubulointerstitial level [8]. The amyloidal deposits at kidney level are accompanied by proteinuria and progressive degradation of the renal function. Other renal manifestations have also been described during the evolution of the inflammatory bowel disease: acute tubulointerstitial nephrites, as extra-intestinal manifestations [9][10], chronic granulomatosic interstitial nephritis related to inflammatory bowel diseases. Several epidemiologic studies have shown that 5-aminosalicylates used in the therapy of inflammatory bowel diseases present risks of nephrotoxicity. Its incidence in patients treated with 5-aminosalicylates is under 0.5% cases [11][12]. The clinical manifestations of nephrotoxicity usually appears within the first year of therapy, but cases ROM. J. INTERN. MED., 2011, 49, 2, 113–120