Long-term outcome of biopsy-proven idiopathic tubulointersitial nephritis with or without uveitis in children:a nationwide follow-up study
| Autor: | Timo Jahnukainen, Matti Nuutinen, Janne Kataja, Juuso Tainio, Sari Rytkönen, Pekka Arikoski, Ville Saarela, Kira Endén |
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| Přispěvatelé: | Tampere University, Department of Paediatrics, HUS Children and Adolescents, Children's Hospital, Clinicum |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Nephrology
medicine.medical_specialty ACUTE INTERSTITIAL NEPHRITIS Adolescent Biopsy 030232 urology & nephrology Renal function 3121 Internal medicine Gastroenterology Uveitis 03 medical and health sciences 0302 clinical medicine DQ 3123 Gynaecology and paediatrics Internal medicine Medicine Humans Child Glucocorticoids ASSOCIATIONS Retrospective Studies Outcome Proteinuria medicine.diagnostic_test business.industry HLA-DR Infant Stage 5 chronic kidney disease medicine.disease 3. Good health Discontinuation Treatment Outcome Tubular proteinuria TIN Child Preschool Pediatrics Perinatology and Child Health 030221 ophthalmology & optometry Nephritis Interstitial Original Article medicine.symptom EXTRAINTESTINAL MANIFESTATION business TINU Nephritis Follow-Up Studies |
| Zdroj: | Pediatric Nephrology (Berlin, Germany) |
| Popis: | BackgroundOnly 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.MethodsAll 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.ResultsFifty-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/1.73m2(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/1.73m2(median 83; 61–89 ml/min/1.73m2). 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.ConclusionsOur 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.Graphical abstractA higher resolution version of the Graphical abstract is available as Supplementary information |
| Databáze: | OpenAIRE |
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