Long-term Outcome of Biopsy-proven Idiopathic Tubulointersitial Nephritis with or Without Uveitis in Children-a Nationwide Follow-up Study

Overview

Journal Pediatr Nephrol

Specialties Nephrology
Pediatrics

Date 2021 May 19

PMID 34008125

Citations 2

Authors

Sari Rytkonen

Juuso Tainio

Ville Saarela

Kira Enden

Janne Kataja

Pekka Arikoski

Matti Nuutinen

Timo Jahnukainen

Affiliations

Soon will be listed here.

Abstract

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 (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 (median 83; 61-89 ml/min/1.73m). 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.

Citing Articles

Tubulointerstitial nephritis and uveitis in children during the COVID-19 pandemic: report of four cases.

Sakhinia F, Brice V, Ollerenshaw R, Gajendran S, Ashworth J, Shenoy M J Nephrol. 2023; 36(5):1451-1455.

PMID: 36848016 PMC: 9969945. DOI: 10.1007/s40620-022-01564-x.

Renal Prognosis in Children With Tubulointerstitial Nephritis and Uveitis Syndrome.

Chevalier A, Duflos C, Clave S, Boyer O, Hogan J, Lahoche A Kidney Int Rep. 2021; 6(12):3045-3053.

PMID: 34901573 PMC: 8640547. DOI: 10.1016/j.ekir.2021.09.017.

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