Aetiology, course and treatment of acute tubulointerstitial nephritis in paediatric patients: a cross-sectional web-based survey.
Wente-Schulz, Sarah; Aksenova, Marina; Awan, Atif; Ambarsari, Cahyani Gita; Becherucci, Francesca; Emma, Francesco; Fila, Marc; Francisco, Telma; Gokce, Ibrahim; Gülhan, Bora; Hansen, Matthias; Jahnukainen, Timo; Kallash, Mahmoud; Kamperis, Konstantinos; Mason, Sherene; Mastrangelo, Antonio; Mencarelli, Francesca; Niwinska-Faryna, Bogna; Riordan, Michael; Rus, Rina R; Saygili, Seha; Serdaroglu, Erkin; Taner, Sevgin; Topaloglu, Rezan; Vidal, Enrico; Woroniecki, Robert; Yel, Sibel; Zieg, Jakub; Pape, Lars
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.
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