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Aetiology, course and treatment of acute tubulointerstitial nephritis in paediatric patients: a cross-sectional web-based survey
S. Wente-Schulz, M. Aksenova, A. Awan, CG. Ambarsari, F. Becherucci, F. Emma, M. Fila, T. Francisco, I. Gokce, B. Gülhan, M. Hansen, T. Jahnukainen, M. Kallash, K. Kamperis, S. Mason, A. Mastrangelo, F. Mencarelli, B. Niwinska-Faryna, M. Riordan,...
Language English Country Great Britain
Document type Journal Article
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- MeSH
- Child MeSH
- Adult MeSH
- Internet MeSH
- Nephritis, Interstitial * MeSH
- Humans MeSH
- Prospective Studies MeSH
- Cross-Sectional Studies MeSH
- Retrospective Studies MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
BACKGROUND: Acute 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 SETTING: We 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. RESULTS: Thirty-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. CONCLUSIONS: Despite 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.
Department of Pediatric Nephrology Aarhus University Hospital Aarhus Denmark
Department of Pediatric Nephrology Bambino Gesù Children's Hospital Roma Italy
Department of Pediatric Nephrology Connecticut Children's Medical Center Hartford Connecticut USA
Department of Pediatric Nephrology Dona Estefânia Hospital Lisboa Portugal
Department of Pediatric Nephrology Dr Behcet Uz Children Hospital Izmir Turkey
Department of Pediatric Nephrology Faculty of Medicine Ege University Izmir Turkey
Department of Pediatric Nephrology Faculty of Medicine Erciyes University Kayseri Turkey
Department of Pediatric Nephrology Faculty of Medicine Hacettepe University Ankara Turkey
Department of Pediatric Nephrology Faculty of Medicine Marmara University Istanbul Turkey
Department of Pediatric Nephrology Karolinska University Hospital Stockholm Sweden
Department of Pediatric Nephrology Meyer Children's Hospital Florence Italy
Department of Pediatric Nephrology MHH Hannover Germany
Department of Pediatric Nephrology Nationwide Children's Hospital Columbus Ohio USA
Department of Pediatric Nephrology Stony Brook Children's Hospital Stony Brook New York USA
Department of Pediatric Nephrology Temple Street Children's University Hospital Dublin Ireland
Department of Pediatric Nephrology University Children's Hospital Ljubljana Slovenia
Department of Pediatric Nephrology University Hospital of Padova Padova Italy
Department of Pediatrics 2 University Hospital Essen Essen Germany
KfH Centre of Pediatric Nephrology Clementine Kinderhospital Frankfurt am Main Germany
References provided by Crossref.org
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