Acute tubulointerstitial nephritis in Scotland

Abstract

Incidence of biopsy-proven ATIN in Scotland has been rising over the past decade with the majority of cases drug induced. Evidence supporting corticosteroid treatment is lacking.

Long-term outcome in biopsy-proven acute interstitial nephritis treated with steroids

“…There is conflicting evidence from retrospective series, with some studies suggesting a benefit for steroids, with faster and greater recovery of renal function [12, 22], whereas other studies have showed no benefit of steroid treatment [5, 7, 24]. The outcomes of recent published series are summarized in Table 2.…”

“…Valluri et al . [7] reported no significant difference in serum creatinine in steroid-treated and untreated patients with D-AIN. Steroid-treated patients had more severe AKI at the time of biopsy, suggesting greater improvement in renal function in these patients compared with those not treated.…”

“…The role of steroids in treatment of AIN remains controversial, with no prospective randomized controlled trials and conflicting evidence from retrospective series [6, 7, 21–24]. There are several small series showing a benefit for steroids when AIN is due to sarcoidosis [25, 26].…”

Effectiveness of corticosteroid compared with non‐corticosteroid therapy for the treatment of drug‐induced acute interstitial nephritis: a systematic review

“…Two trends can be observed from the serum creatinine data: first, patients in more recent studies had better renal function at baseline than patients in older studies; second, patients treated with corticosteroids had poorer renal function compared with those who did not receive corticosteroid therapy. More recent studies have attempted to report renal function before the onset of DI‐AIN …”

“…The need for RRT was reported in six studies; however, the time point reported for initiation varied across studies, including two studies where the time point was unclear. Two studies reported the need for RRT around the time of biopsy .…”