Interstitial Nephritis in Children

Verghese, Priya S.; Luckritz, Kera E.; Eddy, Allison A.

doi:10.1007/978-3-662-52972-0_38

Cited by 5 publications

(4 citation statements)

References 142 publications

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Section: Introductionmentioning

confidence: 99%

“… 7 8 Other TIN cases are presumed to be idiopathic. 4 Despite the different aetiologies of TIN, a common immune-mediated pathogenic mechanism is assumed. Antigen-mediated cellular immune responses seem to play a key role in the pathogenesis of TIN.…”

Section: Introductionmentioning

confidence: 99%

“…Clinical symptoms of TIN are often non-specific and therefore may lead to delayed diagnosis and treatment. 4 10 …”

Section: Introductionmentioning

confidence: 99%

“…Renal histopathology in TIN is characterised by interstitial cellular infiltrates and oedema, but vessels and glomeruli are typically spared. 4 The inflammatory process may eventually lead to interstitial fibrosis and chronic kidney disease. 5 Numerous causes of TIN are known, with drugs, especially non-steroidal antiinflammatory drugs (NSAIDs), being the trigger in 60%-70% of cases 6 ; however, the identity of the causative agent in cases of TIN is usually speculative.…”

Section: Introductionmentioning

confidence: 99%

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Aetiology, course and treatment of acute tubulointerstitial nephritis in paediatric patients: a cross-sectional web-based survey

Wente-Schulz¹,

Aksenova

Awan

et al. 2021

BMJ Open

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BackgroundAcute tubulointerstitial nephritis (TIN) is a significant cause of acute renal failure in paediatric and adult patients. There are no large paediatric series focusing on the aetiology, treatment and courses of acute TIN.Patients, design and settingWe collected retrospective clinical data from paediatric patients with acute biopsy-proven TIN by means of an online survey. Members of four professional societies were invited to participate.ResultsThirty-nine physicians from 18 countries responded. 171 patients with acute TIN were included (54% female, median age 12 years). The most frequent causes were tubulointerstitial nephritis and uveitis syndrome in 31% and drug-induced TIN in 30% (the majority of these caused by non-steroidal anti-inflammatory drugs). In 28% of patients, no initiating noxae were identified (idiopathic TIN). Median estimated glomerular filtration rate (eGFR) rose significantly from 31 at time of renal biopsy to 86 mL/min/1.73 m2 3–6 months later (p<0.001). After 3–6 months, eGFR normalised in 41% of patients (eGFR ≥90 mL/min/1.73 m2), with only 3% having severe or end-stage impairment of renal function (<30 mL/min/1.73 m2). 80% of patients received corticosteroid therapy. Median eGFR after 3–6 months did not differ between steroid-treated and steroid-untreated patients. Other immunosuppressants were used in 18% (n=31) of patients, 21 of whom received mycophenolate mofetil.ConclusionsDespite different aetiologies, acute paediatric TIN had a favourable outcome overall with 88% of patients showing no or mild impairment of eGFR after 3–6 months. Prospective randomised controlled trials are needed to evaluate the efficacy of glucocorticoid treatment in paediatric patients with acute TIN.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Clinical symptoms of TIN are often non-specific and therefore may lead to delayed diagnosis and treatment. 4 10 …”

Section: Introductionmentioning

confidence: 99%