Acute Renal Failure in a Patient with Crohn’s Disease
by Vincent M. Brandenburg, MD (1) Marie-Luise Berres, MD (2) Department of Nephrology (1), Department of Gastroenterology (2) University Hospital Aachen, Germany
Corresponding author:
Vincent M. Brandenburg, MD Department of Nephrology & Clinical Immunology University Hospital Aachen Pauwelsstraße 30 D-52057 Aachen Germany Phone: 0049 – 241 – 8036072 FAX: 0049 – 241 – 8082446 Email: Vincent.Brandenburg@post.rwth-aachen.de
Case Vignette: A 50-year old woman was admitted to our hospital with acute renal failure. Serum creatinine levels had been normal 6,5 months ago, calculated GFR was 65 ml/min at that time. In her late twenties Crohn’s disease had been diagnosed. In the past few years the patient has developed chronic relapsing disease. At the time of admission she had been treated with 20 mg prednisolone per day for 2 months (monotherapy). Eight days before admission the patient started preparing for colonoscopy with 2 bottles of Fleet® Phospho-soda. Colonoscopy was scheduled due to increasing abdominal pain and the re-onset of diarrhea. The examination revealed signs of acute exacerbation. Four days before admission she started feeling generalized malaise and discomfort. Two days later she noticed mild ankle edema. On the day of admission she experienced tetany (left carpopedal spasm). She was on a normal Western diet.
Question 1) - What are the possible causes of acute kidney injury or chronic kidney disease in a patient with Crohn’s disease? (Only ONE answer is correct)