Long-term outcome of biopsy-proven idiopathic tubulointersitial nephritis with or without uveitis in children-a nationwide follow-up study.

Autor: Rytkönen S; Department of Children and Adolescents and PEDEGO Research Unit, Oulu University, Oulu, Finland.; Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland., Tainio J; Department of Paediatric Nephrology and Transplantation, New Children's Hospital, University of Helsinki and Helsinki University Hospital, Box 347, Stenbäckinkatu 9, 00029, Helsinki, HUS, Finland., Saarela V; Department of Ophthalmology, Oulu University Hospital, Oulu, Finland., Endén K; Department of Paediatrics, Tampere University Hospital, Tampere, Finland., Kataja J; Department of Paediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland., Arikoski P; Department of Paediatrics, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland., Nuutinen M; Department of Children and Adolescents and PEDEGO Research Unit, Oulu University, Oulu, Finland.; Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland., Jahnukainen T; Department of Paediatric Nephrology and Transplantation, New Children's Hospital, University of Helsinki and Helsinki University Hospital, Box 347, Stenbäckinkatu 9, 00029, Helsinki, HUS, Finland. timo.jahnukainen@hus.fi.
Jazyk: angličtina
Zdroj: Pediatric nephrology (Berlin, Germany) [Pediatr Nephrol] 2021 Nov; Vol. 36 (11), pp. 3663-3671. Date of Electronic Publication: 2021 May 18.
DOI: 10.1007/s00467-021-05060-5
Abstrakt: Background: Only a few studies reporting the long-term outcome of children with idiopathic tubulointerstitial nephritis (TIN) and uveitis syndrome (TINU) are available. We studied the long-term kidney and ocular outcome in a nationwide cohort of children with TIN or TINU.
Methods: All patients followed up for a minimum of 1 year by a paediatrician and an ophthalmologist were enrolled. The data on plasma creatinine (P-Cr), estimated glomerular filtration rate (eGFR), proteinuria, hypertension and uveitis were collected retrospectively.
Results: Fifty-two patients were studied. Median age at time of diagnosis was 13.1 (1.8-16.9) years and median follow-up time was 5.7 (1.1-21.2) years. Forty-five (87%) patients were initially treated with glucocorticoids. The median of the maximum P-Cr was 162 μmol/l (47-1,016) and that of eGFR 47 ml/min/1.73m 2 (8-124). Uveitis was diagnosed in 33 patients (63%) and 21 (40%) patients developed chronic uveitis. P-Cr normalised in a median of 2 months. Eleven (21%) patients had nephritis recurrence during or after discontinuation of glucocorticoids. At the latest follow-up, 13 (25%) patients had eGFR < 90 ml/min/1.73m 2 (median 83; 61-89 ml/min/1.73m 2 ). Six patients had tubular proteinuria; all presented with TIN without uveitis. Seven (13%) patients were hypertensive. Eleven (21%) patients had uveitis. One patient developed uraemia and was later transplanted.
Conclusions: Our study questions the previously reported good long-term kidney and ocular outcome of patients with TIN/TINU. Decreased kidney function and/or ocular co-morbidities may persist for several years; thus, both kidney and ocular follow-up for at least 1 year is warranted. A higher resolution version of the Graphical abstract is available as Supplementary information.
(© 2021. The Author(s).)
Databáze: MEDLINE
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