Urinary manifestations in African American and Caucasian inflammatory bowel disease patients: a retrospective cohort study

Jake Herbert; Emily Teeter; Landen Shane Burstiner; Ralfi Doka; Amor Royer; Anna H Owings; Julia Liu; Sarah C Glover; Pegah Hosseini-Carroll

doi:10.1186/s12894-021-00951-z

Urinary manifestations in African American and Caucasian inflammatory bowel disease patients: a retrospective cohort study

BMC Urol. 2022 Jan 4;22(1):1. doi: 10.1186/s12894-021-00951-z.

Authors

Jake Herbert¹, Emily Teeter², Landen Shane Burstiner³, Ralfi Doka³, Amor Royer⁴, Anna H Owings⁴, Julia Liu⁵, Sarah C Glover⁶, Pegah Hosseini-Carroll⁶

Affiliations

¹ Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Davie, FL, USA. JH2957@mynsu.nova.edu.
² College of Liberal Arts and Sciences, University of Florida, Gainesville, FL, USA.
³ Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Davie, FL, USA.
⁴ Department of Internal Medicine, University of Mississippi Medical Center, Jackson, MS, USA.
⁵ Division of Gastroenterology, Morehouse School of Medicine, Atlanta, GA, USA.
⁶ Department of Digestive Disease, University of Mississippi Medical Center, Jackson, MS, USA.

Abstract

Background: Inflammatory bowel diseases (IBD), like ulcerative colitis (UC) and Crohn's disease (CD), are associated with urinary extra-intestinal manifestations, like urolithiasis and uncomplicated urinary tract infections (UTIs). The literature reviewed for this study identifies an increased association of CD and urolithiasis against the general population as well as UC. Furthermore, the rates in which urinary comorbidities manifest have not been well characterized in cross-race analyses. The purpose of this study is to establish the prevalence of common urinary extra-intestinal manifestations in CD and UC and to further determine at what rate these affect the African American and Caucasian populations.

Methodology: This is a retrospective cohort study using de-identified data collected from a research data base that included 6 integrated facilities associated with one tertiary healthcare center from 2012 to 2019. The electronic chart records for 3104 Caucasian and African American IBD patients were reviewed for frequency of urolithiasis and uncomplicated UTI via diagnosed ICD-10 codes. Comparison between data groups was made using multivariate regressions, t-tests, and chi square tests.

Results: Our study included 3104 patients of which 59% were female, 38% were African American, and 43% were diagnosed with UC. Similar proportions of UC and CD diagnosed patients developed urolithiasis (6.0% vs 6.7%, p = 0.46), as well as uncomplicated UTIs (15.6% vs. 14.9%, p = 0.56). Similar proportions of African American and Caucasian patients developed urolithiasis (5.4% vs 7.0%, p = 0.09), but a higher proportion of African Americans developed uncomplicated UTIs (19.4% vs 12.6%, p ≤ 0.001).

Conclusion: We found similar rates of urolithiasis formation in both UC and CD in this study. Furthermore, these rates were not significantly different between African American and Caucasian IBD populations. This suggests that UC patients have an elevated risk of urolithiasis formation as those patients with CD. Additionally, African Americans with IBD have a higher frequency of uncomplicated UTI as compared to their Caucasian counterparts.

Keywords: Cystitis; Inflammatory bowel disease; Urinary tract infection; Urolithiasis.

Publication types

Comparative Study

MeSH terms

Adult
Aged
Black or African American*
Cohort Studies
Colitis, Ulcerative / complications*
Crohn Disease / complications*
Female
Humans
Male
Middle Aged
Retrospective Studies
Urologic Diseases / epidemiology
Urologic Diseases / etiology*
White People*