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Renal tubular proteinuria in patients with irritable bowel syndrome

O'Brien, AJ; Lamb, EJ; Muller, AF; (2005) Renal tubular proteinuria in patients with irritable bowel syndrome. EUR J GASTROEN HEPAT , 17 (1) 69 - 72.

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Abstract

Objective Irritable bowel syndrome (IBS) is a common condition that is poorly understood. We have previously demonstrated tubular proteinuria in patients with inflammatory bowel disease. This study examined whether tubular proteinuria was a feature of IBS.Methods Eighty control subjects (male:female, 28:52; age range, 20-65 years) and 21 patients with IBS (male:female, 9:12; age range, 16-64 years) (not significant) were recruited. Patients with known renal disease, hypertension, diabetes or microbiological evidence of urinary infection were excluded. The IBS patients all fulfilled the Rome II criteria. None had preceding gastroenteritis. Urinary alpha 1-microglobulin (alpha 1-M) was measured in a second-voided morning urine sample and corrected for urinary concentration by measurement of creatinine. Blood samples were analysed for haematochemical indices including C-reactive protein. Statistical analysis was by unpaired t test.Results None of the IBS patients were reclassified with inflammatory bowel disease over a 5-year follow-up period. All had normal haematochemical parameters. Mean standard deviation urinary alpha 1-M concentrations were significantly higher in IBS patients than controls (IBS patients, 1.17 +/- 0.65 mg/mmol; controls, 0.75 +/- 0.36 mg/mmol; P < 0.01) and exceeded 1.5 mg/mmol (the upper reference limit) in seven patients. There was no difference in urinary alpha 1-M concentrations in the diarrhoea-predominant and constipation-predominant groups (mean standard deviation, 1.342 +/- 0.65 versus 0.76 +/- 0.48 mg/mmol; P = 0.062).Conclusions Urinary alpha 1-M concentration is commonly increased in IBS, suggesting the presence of renal proximal tubular injury. (c) 2005 Lippincott Williams C Wilkins.

Type:Article
Title:Renal tubular proteinuria in patients with irritable bowel syndrome
Keywords:alpha(1)-microglobulin, protein HC, irritable bowel syndrome, kidney disease, proximal tubule, MAST-CELLS, COLONIC MOTILITY, ABDOMINAL-PAIN, DISEASE, INFLAMMATION, DYSFUNCTION, DISTENSION, ACTIVATION, SYMPTOMS, THERAPY

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