Clinical Features and Outcome of Acute Interstitial Nephritis Diagnosed using Urinary Biomarkers - An Observational Study
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Abstract
Background: This study describes the clinical features of acute interstitial nephritis diagnosed histopathologically or by elevated urinary MCP-1.
Materials and Methods: The study was a prospective cross-sectional study conducted at JIPMER, Puducherry, from November 2021 to June 2023. The study participants were hospitalized patients with unexplained acute kidney injury. Acute interstitial nephritis was diagnosed by histopathology or AKI with urinary MCP-1 > 242 ng/mmol Cr after glomerulonephritis/ pyelonephritis had been ruled out. Patients were followed up for a period of 6 months.
Results: 800 patients with acute kidney injury were screened and 30 patients (3.7%) were diagnosed to have AIN. The average age of the patients was 45 years and 86% were males. Of them, 14(47%) patients had oliguria, peripheral eosinophilia was present in 9(30%) patients. The median serum creatinine at presentation was 5 mg/dl (3.0 - 7.3) AIN was drug induced in 25 patients (73%), envenomation related in 5 patients (17%) and due to leptospirosis in 3 patients (10%). Drug induced AIN was due to Proton Pump Inhibitors, NSAIDs or antibiotics. Management primarily comprised of withdrawal of the culprit drug. Corticosteroids were given in 2 patients. Renal replacement therapy was required in 40% of patients. 80% of patients had complete renal recovery at the end of 6 months and 13% progressed to CKD and 2 patients had died.
Conclusion: AIN is seen in less than 5% of patients at our centre in patients presenting with AKI. Complete recovery occurs in 80% of the patients.
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Copyright (c) 2025 Shamanna SB.
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