The development of nephrotoxicity due to the use of meselazine in patients with A diagnosis of inflammatory bowel disease

Inflammatory Bowel Disease ( IBD ); Abdominal pain, diarrhea (with or without blood), weight loss, growth retardation, with chronic course, with periods of well-being and activation, caused by an exaggerated immune response to various antigens or environmental factors in a genetically susceptible person with symptoms; is a group of diseases with subtypes of Ulcerative Colitis and Crohn's disease. Ulcerative Colitis (UC) is characterized by recurrent inflammation of parts of the colon that are limited by the mucous layer. It occurs most often in the rectum and constantly spreads to other parts of the colon. In ulcerative colitis, there are often complaints of recurrent bloody diarrhea. The diagnosis of UC is made clinically by endoscopy and anamnesis. UC is basically a disease of the rectum. Crohn's Disease: Crohn's disease (CH) is an inflammatory disease of the digestive tract that can occur anywhere from the mouth to the anus, accompanied by focal, asymmetric, transmural involvement. Instead of the superficial mucosal involvement with diffuse continuity seen in UC, there is focal transmural involvement in CH. The decisive histological finding of CH is non-caseated granulomas, but they are found only in 30% of patients and are not essential for diagnosis. CH mainly holds the terminal ileum and cecum. Renal Side Effects of Drugs Used to Treat IBD: Aminosalicylates 5 - Aminosalicylates are one of the main treatments for IBD patients. Both the combined formulation of sulfasalazine and its coated forms (mesalazine, oxalazine) have been associated with renal toxicity. Renal impairment can be detected in one out of every hundred patients using ASA, while clinically significant damage is observed in one out of 500 patients. Renal damage due to ASA can be observed in different clinics; glomerulonephritis, minimal change nephropathy with nephrotic syndrome, and interstitial nephritis associated with nephrogenic diabetes insipidus. Mesalazine can provoke the development of acute or chronic interstitial nephritis. The development of TİN due to the use of 5-ASA can be without symptoms, as well as with weakness, fatigue, fever and eoisinophilia. x In our single-center retrospective descriptive study, 161 patients with regular measurements from January 2012 to December 2020, diagnosed in our hospital, over the age of 18, diagnosed with Ulcerative Colitis and Crohn's patients , were treated at the 1st month, 6th month, 12 th month and the last clinic application creatinine values were reached and GFR (GFH) was calculated. In terms of its effect on GFR, the patient's age at diagnosis, gender, comorbidities, kidney toxic drugs used, location of the disease, whether there is extraintestinal involvement, whether had an attack, steroid use during attacks, addition of immunomodulatory treatment and molecular agents during follow-up, smoking, active disease or in remission, Sedimentation, Crp, Bun, Creatinine, Gfr, Sodium, Potassium, Chlorine, Calcium, Ast, Alt, Alp, Ggt, Total Protein, Albumin levels from whole blood and biochemistry values during these follow-ups. First month, 6th month, 12th month and the last application values were recorded. As a result; When the whole patient group was evaluated, an increase in BUN values was found to be significant in the first month, but this significance disappeared over time. Similarly, BUN values of UC patients at 1 month after treatment were higher than BUN values at the time of diagnosis. No similar change was seen in those with Crohn's disease. During the one-year follow-up, no significant change was detected in creatinine and GFR in the UC and CD patient groups and in the group including all patients. No development of drug-related TIN due to examplezine was observed in either group of patients. There was no statistically significant change in BUN, creatinine and GFR values during the 72-month treatment period compared to the 1st year values after treatment. Keywords: Ulcerative Colitis, Crohn's Disease, Mesalazine, Nephrotoxicity