Hadded Sarra, Harzallah Amel, Chargui Soumaya, Hajji Mariem, Kaaroud Hayet, Goucha Rim, Ben Hamida Fathi, Gorsane Imen, Ben Abdallah Taieb
Service de médecine A, hôpital Charles-Nicolle-de-Tunis, boulevard du 9-avril-1938, 1007 Tunis, Bab Saâdoun, Tunisie; Faculté de médecine de Tunis, université de Tunis-El-Manar, 1007 Tunis, Tunisie.
Service de médecine A, hôpital Charles-Nicolle-de-Tunis, boulevard du 9-avril-1938, 1007 Tunis, Bab Saâdoun, Tunisie; Laboratoire de pathologie rénale LR00SP01, hôpital Charles-Nicolle-de-Tunis, boulevard du 9 avril 1938, 1007 Tunis, Bab Saâdoun, Tunisie; Faculté de médecine de Tunis, université de Tunis-El-Manar, 1007 Tunis, Tunisie.
Nephrol Ther. 2021 Apr;17(2):114-119. doi: 10.1016/j.nephro.2020.10.012. Epub 2021 Jan 21.
Acute interstitial nephritis represents a clinically and etiologically heterogeneous group of kidney diseases. The aim of our study was to explore the main causes of biopsy-proven acute interstitial nephritis and to identify predictive factors of renal outcome.
We conducted a retrospective monocentric study which included patients with biopsy proven AIN, followed in our department during the period between 1980 and 2018. The non-recovery of kidney function or an estimated glomerular filtration rate˂60 mL/min/1.73 m were considered as a worse renal outcome.
A total of 65 acute interstitial nephritis patients were enrolled. The mean age of patients was 41.3±16 years with a female predominance (78%). Drug-induced etiology was the most common (29%). The most frequent culprit drugs in our study were NSAID followed by antibiotics. The renal prognosis was unfavorable in 21 cases (32%). The independent predictive factors for renal outcome were : a percentage of sclerotic glomeruli greater than 15% (P=0.004), absence of interstitial edema (P˂0.001), non-use to corticosteroid therapy (P=0.02) and a delay in initiating corticosteroid therapy greater than 21 days (P=0.02).
Drugs currently represent the most common cause of acute interstitial nephritis. The renal prognosis is often favorable, but the progression can be towards chronic renal failure in the event of diagnostic and therapeutic delay. Our data suggest a beneficial influence of steroids on the outcome of acute interstitial nephritis.
急性间质性肾炎是一组临床和病因各异的肾脏疾病。我们研究的目的是探讨经活检证实的急性间质性肾炎的主要病因，并确定肾脏预后的预测因素。
我们进行了一项回顾性单中心研究，纳入了1980年至2018年期间在我们科室随访的经活检证实为急性间质性肾炎的患者。肾功能未恢复或估计肾小球滤过率<60 mL/min/1.73 m²被视为较差的肾脏预后。
共纳入65例急性间质性肾炎患者。患者的平均年龄为41.3±16岁，女性占主导（78%）。药物性病因最为常见（29%）。我们研究中最常见的致病药物是非甾体抗炎药，其次是抗生素。21例（32%）患者的肾脏预后不佳。肾脏预后的独立预测因素为：硬化肾小球百分比大于15%（P=0.004）、无间质水肿（P<0.001）未使用糖皮质激素治疗（P=0.02）以及开始糖皮质激素治疗的延迟大于21天（P=0.02）。
目前药物是急性间质性肾炎最常见的病因。肾脏预后通常较好，但如果诊断和治疗延迟，病情可能会发展为慢性肾衰竭。我们的数据表明糖皮质激素对急性间质性肾炎的预后有有益影响。
