Acute interstitial nephritis in south of Iran: A cross sectional study


Authors:

Zohre khodamoradi1,Maryam Pakfetrat2, Mohammad Mahdi Sagheb3 1 Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran 2 Department of Nephrology, Shiraz University of Medical Sciences, Shiraz, Iran 3 Department of Nephrology, Shiraz University of Medical Sciences, Shiraz, Iran

Correspondence:

Zohre khodamoradi, zohre.khodamoradi@gmail.com

Aim: Acute interstitial nephritis (AIN) is now known to be the most serious cause of AKI. Its prevalence has globally increased during the recent years. There is no sufficient amount of information about prevalence, causes, clinical manifestation of AIN and the outcome of patients in our region. So, in this study we wanted to find the prevalence of AIN and describe the causes, clinical presentation, and the outcome of AIN in the native kidney biopsies.

Methods: From all 2433 patients that admitted with diagnosis of AKI in Namazee hospital and 934 native kidney biopsy reports between 2006 and 2014, pathologic diagnosis of acute interstitial nephritis was collected. All biopsies were taken in Namazee hospital, the only educational hospital offering kidney sampling in Fars province. We excluded kidney transplanted biopsies and patients younger than 16 years of age. We gathered data by questionnaire.

Results: Prevalence of AIN in our center during 2005 to 2014 was 2.5 % of all renal biopsies and 0.98% of all adults with AKI that were admitted in our center.The common cause of AIN in our study is drugs; the three most common culprit drugs were NSAID 5, antibiotics 4 and PPI 4. Of those patients admitted to hospital due to AKI with impression of AIN 17 patients (70%) received corticosteroid and five of them (29.4٪) received pulse of corticosteroid and 12 of them (70.6٪) received oral and 54.2% of the patients had hemodialysis. Eight patients out of the total had received both dialysis and corticosteroid. The outcome is based on the interview with patients after discharge who recovered (normal serum creatinine and no need to use drugs or dialysis) and those who didn't (patients who became end-stage renal disease (ESRD), had kidney transplantation, need dialysis or continue steroid therapy with high creatinine). No difference in outcome was detected between the two groups of treatment.

Conclusions: In our region prevalence of AIN is like the prevalence of AIN in the world. We found that the common cause of AIN in our study is drugs.

Keywords: acute interstitial nephritis; etiology; steroid treatment; kidney biopsy, Iran.