Interstitial nephritis natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [[1]]; Associate Editor(s)-in-Chief:Mohsen Basiri M.D.

Overview

In the majority of patients with TIN, recovery of renal function has been observed, and improvement immediately occurs upon stopping the offensive agent.

Nevertheless, about 12% of patients may progress to develop ESRD and its complications; and thus require dialysis or transplantation.

However there is no definite prognostic indicators for TIN, but renal failure lasts for >3 weeks, older patients and presence of tubular atrophy and interstitial fibrosis in the renal biopsy are associated with worse prognosis.

Natural History, Complications, and Prognosis

Natural History

In the majority of patients with TIN, a full recovery or partial recovery occurs upon stopping the offensive agent. Meanwhile,about 12% of patients may progress to ESRD and its complications; and thus require dialysis or transplantation.^[1]

Complications

Common complications of TIN include:

Prognosis

In the majority of patients with TIN, a full recovery or partial recovery occurs upon stopping the offensive agent. Meanwhile,about 12% of patients may progress to ESRD and its complications; and thus require dialysis or transplantation.^[1]

It has been suggested that the long-term prognosis is worse if:

Renal failure lasts for >3 weeks.^[2]^[3] The opening <ref> tag is malformed or has a bad name
Older patients^[4]
Presence of tubular atrophy and interstitial fibrosis in the renal biopsy.The opening <ref> tag is malformed or has a bad name ^[5]

References

↑ ^1.0 ^1.1 Baker, R. J.; Pusey, C. D. (2004). “The changing profile of acute tubulointerstitial nephritis”. Nephrology Dialysis Transplantation. 19 (1): 8–11. doi:10.1093/ndt/gfg464. ISSN 0931-0509.
↑ Ditlove J, Weidmann P, Bernstein M, Massry SG. Methicillin nephritis. Med Balt 1977; 56: 483–491
↑ Laberke HG, Bohle A. Acute interstitial nephritis: correlations between clinical and morphological findings. Clin Nephrol 1980; 14: 263–273
↑ Kida H, Abe T, Tomosugi N et al. Prediction of the long-term outcome in acute interstitial nephritis. Clin Nephrol 1984; 22: 55–60
↑ Bhaumik SK, Kher V, Arora P et al. Evaluation of clinical and histological prognostic markers in drug-induced acute interstitial nephritis. Ren Fail 1996; 18: 97–104

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[BakerPusey2004-1] 1.0 ^1.1 Baker, R. J.; Pusey, C. D. (2004). “The changing profile of acute tubulointerstitial nephritis”. Nephrology Dialysis Transplantation. 19 (1): 8–11. doi:10.1093/ndt/gfg464. ISSN 0931-0509.

[2] Ditlove J, Weidmann P, Bernstein M, Massry SG. Methicillin nephritis. Med Balt 1977; 56: 483–491

[3] Laberke HG, Bohle A. Acute interstitial nephritis: correlations between clinical and morphological findings. Clin Nephrol 1980; 14: 263–273

[4] Kida H, Abe T, Tomosugi N et al. Prediction of the long-term outcome in acute interstitial nephritis. Clin Nephrol 1984; 22: 55–60

[5] Bhaumik SK, Kher V, Arora P et al. Evaluation of clinical and histological prognostic markers in drug-induced acute interstitial nephritis. Ren Fail 1996; 18: 97–104

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