162 EXPERIENCE OF 5-ASA NEPHROTOXICITY IN THE UNITED KINGDOM

A. Jayaprakash¹, P.E. Stevens¹, S. Mian², A.S. McIntyre³, R.F. Logan⁴, A.F. Muller¹. ¹The Kent & Canterbury Hospital, Kent;²BSG Research Unit, London;³Wycombe Hospital, Bucks;⁴University Hospital, Nottingham, UK

Nephrotoxicity is an unusual complication of 5 amino-salicylic acid (5-ASA) therapy in inflammatory bowel disease. The literature documenting its frequency, severity & recovery is limited. This study assessed the retrospective experience of all 1298 names on the British Society of Gastroenterology (BSG) register and 237 Consultant members of the Renal Association (RA).

Each was sent a detailed questionnaire asking for patient demographic details, frequency with which renal function was assessed, time to development of renal impairment, drug(s) thought to be responsible, renal function at diagnosis and recovery, renal biopsy histology & any other relevant information.

Results: See table⇓. 72 BSG respondents measured renal function less than once per year; 27 never measured it. Responsible agents for nephrotoxicity were: [BSG (RA)] Asacol 132(29), Colazide 1(1), Olsalazine 3(1), Pentasa 12(2), Salofalk 1(0), & Sulphasalazine 13(8). *The BSG reported 6 pts needing dialysis & 7 a renal transplant. The RA reported medico-legal action in 4 cases.

All 5-ASA's may cause severe nephrotoxicity, which at best may only be partially reversible. Most cases occurred with Asacol, many after more than 12 months of therapy. The BSG Research Unit is collecting prospective data that may help in determining associated factors and whether nephrotoxicity can be avoided by frequent monitoring.

163 THE IMPACT OF NEW REFERRAL GUIDELINES ON DELAYS IN THE DIAGNOSIS OF OESOPHAGO-GASTRIC CANCER

P.J. Lamb, J. Wayman, M. Billings, M. Irving, D. Karat, N. Hayes, S.A. Raimes, S.M. Griffin. Northern Oesophago-Gastric Cancer Unit at the Royal Victoria Infirmary, Newcastle upon Tyne & Cumberland Infirmary, Carlisle, UK

Background: Early diagnosis is vital to improve the outcome for patients with oesophago-gastric cancer. …