UTIs Prevalent in IBD, Urinary Calculi Patients

Patients suffering from inflammatory bowel disease (IBD) who also have urinary calculi were recently found more likely to experience urinary tract infections, renal failure, and sepsis.

Patients suffering from inflammatory bowel disease (IBD) who also have urinary calculi were recently found more likely to experience urinary tract infections, renal failure, and sepsis.

The prevalence of severely infected urolithiasis among these patients inevitably suggests stone disease screening, improved outpatient medical management, as well as early elective surgery for the detected stones.

The study, published in the journal Urology, was led by Naeem Bhojani, MD, Division of Urology, Universite de Montreal, Montreal, Canada. Bhojani and his colleagues compared a sample of patients afflicted with IBD and urolithiasis with a group of individuals with urinary stone formations, who were then admitted to US emergency departments with infected urolithiasis. The researchers identified those specific patients from the Nationwide Emergency Department Sample between 2006 and 2009.

The results revealed that a total of 14,352 patients had both IBD and urolithiasis. Bhojani noted IBD patients with urolithiasis presented with infections (10.4% vs 9.1%), sepsis (0.6% vs 0.2%), and end-organ failure (6.3% vs 1.6%) more frequently than the non-IBD patients.

Results also indicated these patients were more likely to have characteristics independently associated with infection and sepsis, such as older age and female gender. Furthermore, IBD was found “to be an independent predictor of infection, sepsis, and admission”.

Study resultsunderscored that IBD patients presenting to the ED with urolithiasis would have a higher probability of developing concurrent infections, sepsis, and end-organ damage — requiring hospitalization.

According to the research, effective efforts to prevent emergent presentations surrounded methods of screening for urolithiasis and early operative intervention.

The team concluded, “A multidisciplinary approach involving urologists, gastroenterologists, nephrologists, and dietitians could help reduce the frequency and intensity of stone disease in this at-risk population.”