Interstitial nephritis natural history, complications and prognosis: Difference between revisions
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{{Interstitial nephritis}} | |||
'''Editor-In-Chief:''' [[User:C Michael Gibson|C. Michael Gibson, M.S., M.D.]] [[Mailto:charlesmichaelgibson@gmail.com| [1]]]; '''Associate Editor(s)-in-Chief:'''{{M.B}} | '''Editor-In-Chief:''' [[User:C Michael Gibson|C. Michael Gibson, M.S., M.D.]] [[Mailto:charlesmichaelgibson@gmail.com| [1]]]; '''Associate Editor(s)-in-Chief:'''{{M.B}} | ||
== Overview == | == Overview == | ||
In the | 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 [[Organ transplant|transplantation]]. | |||
However there is no definite prognostic indicators for TIN, but [[Renal insufficiency|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, Complications, and Prognosis == | ||
=== Natural History === | === 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.<ref name="BakerPusey2004">{{cite journal|last1=Baker|first1=R. J.|last2=Pusey|first2=C. D.|title=The changing profile of acute tubulointerstitial nephritis|journal=Nephrology Dialysis Transplantation|volume=19|issue=1|year=2004|pages=8–11|issn=0931-0509|doi=10.1093/ndt/gfg464}}</ref> | ||
=== Complications === | === Complications === | ||
* Common complications of TIN include: | * Common complications of TIN include: | ||
** Hypertension | ** [[Hypertension]] | ||
** | ** [[Hypokalemia]] | ||
** ESRD | ** [[hypouricemia]] | ||
** [[hypophosphatemia]] | |||
** [[metabolic acidosis]] | |||
** [[Proteinuria]] | |||
** [[ESRD]] | |||
==Prognosis== | ==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. | 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.<ref name="BakerPusey2004">{{cite journal|last1=Baker|first1=R. J.|last2=Pusey|first2=C. D.|title=The changing profile of acute tubulointerstitial nephritis|journal=Nephrology Dialysis Transplantation|volume=19|issue=1|year=2004|pages=8–11|issn=0931-0509|doi=10.1093/ndt/gfg464}}</ref> | ||
==== It has been suggested that the long-term prognosis is worse if: ==== | ==== It has been suggested that the long-term prognosis is worse if: ==== | ||
* Renal failure lasts for >3 weeks.<ref>Ditlove J, Weidmann P, Bernstein M, Massry SG. Methicillin nephritis. Med Balt 1977; 56: 483–491</ref><ref>Laberke HG, Bohle A. Acute interstitial nephritis: correlations between clinical and morphological findings. Clin Nephrol 1980; 14: 263–273</ref> <ref /> | * Renal failure lasts for >3 weeks.<ref>Ditlove J, Weidmann P, Bernstein M, Massry SG. Methicillin nephritis. Med Balt 1977; 56: 483–491</ref><ref>Laberke HG, Bohle A. Acute interstitial nephritis: correlations between clinical and morphological findings. Clin Nephrol 1980; 14: 263–273</ref> <ref /> | ||
* Older patients<ref>Kida H, Abe T, Tomosugi N et al. Prediction of the long-term outcome in acute interstitial nephritis. Clin Nephrol 1984; 22: 55–60</ref> | * Older patients<ref>Kida H, Abe T, Tomosugi N et al. Prediction of the long-term outcome in acute interstitial nephritis. Clin Nephrol 1984; 22: 55–60</ref> | ||
* Presence of tubular atrophy and interstitial fibrosis in the renal biopsy.<ref /> <ref | * Presence of tubular atrophy and interstitial fibrosis in the renal biopsy.<ref /> <ref>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</ref> | ||
==References== | ==References== | ||
Latest revision as of 02:06, 2 August 2018
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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]
- Older patients[4]
- Presence of tubular atrophy and interstitial fibrosis in the renal biopsy. [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