PMID- 22817666
OWN - NLM
STAT- MEDLINE
DCOM- 20130422
LR  - 20220129
IS  - 1440-1797 (Electronic)
IS  - 1320-5358 (Linking)
VI  - 17
IP  - 8
DP  - 2012 Nov
TI  - Acute tubulointerstitial nephritis, treatment with steroid and impact on renal 
      outcomes.
PG  - 748-53
LID - 10.1111/j.1440-1797.2012.01648.x [doi]
AB  - BACKGROUND: The use and timing of steroids in the management of acute 
      tubulointerstitial nephritis (ATIN) remains debatable. AIMS: To determine the 
      incidence and aetiology of ATIN in our unit, and to examine trends in the use of 
      steroids and their impact on renal outcomes. METHODS: Patients with a 
      histological diagnosis of ATIN over a 9-year period were identified and divided 
      into steroid-treated (StG) and steroid-naive groups (SnG). Mean change in 
      estimated glomerular filtration rate (eGFR) was determined. RESULTS: Forty-nine 
      patients had ATIN as their main diagnosis, 67% of cases were drug-induced, and 
      proton pump inhibitors (PPI) were the second commonest implicated drug category. 
      Majority (75%) of patients received steroids, and eGFR improved to a 
      significantly greater degree in these steroid-treated patients (3.4-fold 
      improvement vs 2.0-fold in SnG; P < 0.05, unpaired t-test). Despite comparable 
      eGFR at presentation (StG: 11.7; SnG: 15.4), steroid-treated patients were less 
      likely to receive dialysis, although not significantly so (OR 0.27; 95% CI 
      0.06-1.15, P = 0.066, chi-squared test). However, there was no significant 
      relation between the degree of eGFR improvement and delay in starting steroids 
      (Pearson r = -0.25, P > 0.45), and no difference in eGFR at the time of last 
      follow-up (StG: 33 +/- 3; SnG: 32 +/- 7; P > 0.9, unpaired t-test). CONCLUSION: StG 
      patients had a greater degree of improvement in renal function, but with no 
      correlation between degree of improvement in eGFR and delay in starting steroids, 
      and similar eGFR values at final follow-up. PPI were the second commonest drug 
      category among drug-induced cases.
CI  - (c) 2012 The Authors. Nephrology (c) 2012 Asian Pacific Society of Nephrology.
FAU - Raza, Muhammad N
AU  - Raza MN
AD  - Royal Devon and Exeter Hospital, Exeter, UK. muhammad.raza@glos.nhs.uk
FAU - Hadid, Muhammad
AU  - Hadid M
FAU - Keen, Charles E
AU  - Keen CE
FAU - Bingham, Coralie
AU  - Bingham C
FAU - Salmon, Andrew H J
AU  - Salmon AH
LA  - eng
GR  - G0802829/MRC_/Medical Research Council/United Kingdom
PT  - Journal Article
PL  - Australia
TA  - Nephrology (Carlton)
JT  - Nephrology (Carlton, Vic.)
JID - 9615568
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Proton Pump Inhibitors)
RN  - 0 (Steroids)
RN  - Acute Tubulointerstitial Nephritis
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anti-Bacterial Agents/adverse effects
MH  - Biopsy
MH  - Chi-Square Distribution
MH  - England/epidemiology
MH  - Female
MH  - Glomerular Filtration Rate/*drug effects
MH  - Humans
MH  - Incidence
MH  - Kidney/*drug effects/pathology/physiopathology
MH  - Male
MH  - Middle Aged
MH  - Nephritis, Interstitial/diagnosis/*drug therapy/epidemiology/physiopathology
MH  - Odds Ratio
MH  - Proton Pump Inhibitors/adverse effects
MH  - Recovery of Function
MH  - Renal Dialysis
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Steroids/*therapeutic use
MH  - Time Factors
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2012/07/24 06:00
MHDA- 2013/04/23 06:00
CRDT- 2012/07/24 06:00
PHST- 2012/07/24 06:00 [entrez]
PHST- 2012/07/24 06:00 [pubmed]
PHST- 2013/04/23 06:00 [medline]
AID - 10.1111/j.1440-1797.2012.01648.x [doi]
PST - ppublish
SO  - Nephrology (Carlton). 2012 Nov;17(8):748-53. doi: 
      10.1111/j.1440-1797.2012.01648.x.