Tubulointerstitial nephritis and uveitis syndrome: a systematic review

Abstract

Background Tubulointerstitial nephritis and uveitis (TINU) is defined as the occurrence of tubulointerstitial nephritis and uveitis in the absence of other systemic diseases. The most comprehensive review on this condition was published in 2001. Methods We conducted a systematic review of the literature on cases of TINU syndrome. Medline an EMBASE databases were screened. Full-length articles or letters reporting cases with both tubulointerstitial nephritis and uveitis were selected. We investigated differences between males/females and pediatric and adult cases. Multivariate analysis was performed to identify potential risk factors for chronic kidney disease development. Results 233 articles reporting 592 TINU cases were retained for analysis. The median age of the included subjects was 17 (interquartile range 13-46) years, with a female predominance (65%). Uveitis most frequently (52%) followed renal disease, and was mostly anterior (65%) and bilateral (88%). Children tended to have more ocular relapses while they were slightly less likely than adults to suffer from acute kidney injury and to develop chronic kidney disease. Adult age, as well as posterior or panuveitis, were associated with an increased risk of developing chronic kidney disease. Conclusions TINU affects both children and adults, with some differences between these two categories. Adult age and the presence of a posterior uveitis or panuveitis appear to be associated with the development of chronic kidney disease.

Renal Prognosis in Children With Tubulointerstitial Nephritis and Uveitis Syndrome

“…The renal prognosis of TINU syndrome is usually described as favorable: recent data from Hayashi et al showed a good renal outcome in a series of 29 children 11 . The same conclusion was drawn from data collected recently by Regusci et al in a systematic review of the literature 12 . Nevertheless, recent studies have highlighted that 70 to 96% of adult TINU patients have chronic kidney failure on long-term follow-up 13,14 .…”

“…We showed that children with TINU syndrome may have a poor renal prognosis. Although TINU syndrome is usually described as having a favorable renal outcome 2,12,13,22 , several recent studies suggest that a full kidney recovery is not always achieved especially in adult patients. Indeed, Legendre et al reported that two-thirds of their patients (24/35) had abnormal kidney function (eGFR <90 mL/min/1.73m²) at 1 year of follow-up 14 .…”

Concomitant Proton Pump Inhibitors and Immune Checkpoint Inhibitors Increase Nephritis Frequency

“…The most common trigger of AIN is the drug used (46), therefore the identification of the types of drug is important in determining a preventive strategy. Although our results provide new insights of ICPI-and PPI-induced nephritis, further basic and clinical studies are required to elucidate the mechanisms of action.…”

A Young Man With Acute Kidney Injury and Uveitis: An Unusual Presentation and Case Report

“…The underlying pathophysiology remains unclear to date; however, TINU is believed to be triggered by infection or with the use of certain medications (antibiotics or nonsteroidal anti-inflammatory drugs) [2]. This syndrome is reported to have a female predominance (65% of cases) and a median age of 17 [3]. It is reported that TINU is responsible for 5% of the cases of acute tubulointerstitial nephritis [4].…”