Introduction:
Acute Interstitial Nephritis (AIN) is a major cause of acute kidney injury (AKI) that may require tissue diagnosis to determine the specific cause and treatment if renal function does not recover. Our understanding of the long-term outcomes of AIN and the effectiveness of steroid treatment is currently limited to a few studies. This prompts us to assess these aspects through this study thoroughly.
Methods:
Records of all biopsy-proven cases of AIN between January 2013 and December 2022 were collected from the electronic database of the institute.
Results:
Out of 4267 biopsies screened, 170 (3.9%) with features indicative of AIN were included in the study. Causes of AIN included drugs (73.5%), infection-induced AIN (14.1%), crystal-associated AIN (5.8%), unknown causes (4.1%), and snake bites (1.2%). Corticosteroid was used in 121 patients (71.2%), with 98 patients (57.6%) showing renal recovery and 30 patients (17.6%) exhibiting self-renal recovery without steroid therapy (P=0.01) on median follow-up of 13 months (IQR=3-44). Median eGFR at 3 months in steroid-treated group (42.3 ml/min) was more than in no steroid group (30.8 ml/min) (P =0.03). The steroid treatment group had 31.9% fewer patients requiring RRT in the follow-up (P=0.01). Patient and renal survival was more in steroid treated group (P= 0.01, P=0.03 respectively).
Conclusions:
Patients have shown favourable renal responses to steroid therapy after three months and follow-up. Given the significant number of patients with biopsy-proven AIN, it is recommended to consider steroid therapy for renal recovery with caution in cases where AIN continues despite the removal of the offending agent.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.