The package inserts for products containing 5-aminosalicylic acid, or mesalamine, include the following language regarding the risk of adverse kidney effects: “renal impairment, including minimal change nephropathy, acute and chronic interstitial nephritis, and rarely renal failure, has been reported in patients given products such as mesalamine delayed-release tablets that contain mesalamine or are converted to mesalamine.” In this article, we review the data regarding this nephrotoxicity and the recommendations regarding appropriate monitoring. Chronic interstitial nephritis is a rare occurrence in patients treated with these drugs for Crohn disease and ulcerative colitis. Patients often present with asymptomatic reductions in glomerular filtration rate, without accompanying pyuria, skin lesions, or eosinophilia, unlike cases of acute interstitial nephritis. Drug cessation is usually associated with improved kidney function. However, if left undetected, more prolonged exposure to the drug can lead to irreversible kidney failure and end-stage kidney disease. No convincing studies demonstrate efficacy of treatment with corticosteroids. Frequent monitoring of serum creatinine, especially in the first years after initiation of therapy, is recommended.

含有5-氨基水杨酸或美沙拉敏的产品的包装插页中包含以下有关肾脏不良反应风险的语言：“据报道，肾脏损害，包括轻微改变性肾病，急性和慢性间质性肾炎，很少发生肾衰竭。服用美沙明胺缓释片等产品的患者，其中含有美沙明胺或已转化为美沙明胺。” 在本文中，我们回顾了有关这种肾毒性的数据以及有关适当监测的建议。在用这些药物治疗克罗恩病和溃疡性结肠炎的患者中，慢性间质性肾炎很少发生。患者通常无症状地降低肾小球滤过率，而没有伴随的脓尿，皮肤病变或嗜酸性粒细胞增多，不像急性间质性肾炎。戒烟通常与改善肾功能有关。但是，如果不及时发现，更长时间地接触该药物会导致不可逆的肾衰竭和终末期肾脏疾病。没有令人信服的研究表明用皮质类固醇激素治疗有效。建议经常监测血清肌酐，尤其是开始治疗后的头几年。