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Long-term outcome in biopsy-proven acute interstitial nephritis treated with steroids

Prendecki, M; Tanna, A; Salama, AD; Tam, FWK; Caims, T; Taube, D; Cook, HT; ... Pusey, CD; + view all (2017) Long-term outcome in biopsy-proven acute interstitial nephritis treated with steroids. Clinical Kidney Journal , 10 (2) pp. 233-239. 10.1093/ckj/sfw116. Green open access

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Abstract

BACKGROUND: There are no prospective randomized controlled trials describing the outcome of acute interstitial nephritis (AIN) treated with steroids, and retrospective studies are limited. METHODS: We identified adult patients with a diagnosis of AIN without glomerular pathology over a 14-year period. Treated patients all received oral prednisolone and three also recieved IV methylprednisolone. Data were collected retrospectively on estimated glomerular filtration rate (eGFR), change in eGFR from time of biopsy, dependence on renal replacement therapy (RRT) and mortality, and outcomes were analysed according to the treatment prescribed. RESULTS: A total of 187 eligible patients with AIN were identified and 158 were treated with steroids. There was no difference in median eGFR or dependence on RRT at the time of biopsy. Steroid-treated patients had significantly higher eGFR at all time points post-biopsy up to 24 months, when median eGFR was 43 mL/min in the steroid-treated group and 24 mL/min in the untreated group (P  =  0.01). Fewer patients in the steroid-treated group were dialysis dependent by 6 months (3.2% versus 20.6%, P  =  0.0022) and 24 months (5.1% versus 24.1%, P  =  0.0019). CONCLUSIONS: This large retrospective study suggests a benefit of steroids in treatment of AIN with greater improvement in eGFR and fewer patients progressing to end-stage renal disease.

Type: Article
Title: Long-term outcome in biopsy-proven acute interstitial nephritis treated with steroids
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/ckj/sfw116
Publisher version: https://doi.org/10.1093/ckj/sfw116
Language: English
Additional information: © The Author 2016. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/ licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
Keywords: acute interstitial nephritis, renal pathology, steroid therapy
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Renal Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10065953
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