Clinical Pathologic And Prognostic Analysis Of Acute Tubular Interstitial Nephritis

Objective:To improve the diagnosis and understanding of renal function recovery by following up the renal function recovery in patients with acute tubular interstitial nephritis.Methods:We retrospectively analyzed the clinical data of 33 patients with complete follow-up data diagnosed as Acute tubular interstitial nephritis?ATIN?in Jilin Universsity First Hospital from 2009.01 to2017.03.Patients admitted to hospital were given symptomatic supportive therapy,hormone therapy or hemodialysis according to symptoms and renal infiltration.According to whether the patient's eGRF returned to normal after 3 months of treatment,the patients were divided into renal function recovery group and renal function non-recovery group.By comparing the clinical manifestations,laboratory examination indexes and pathological manifestations of the two groups of patients,factors related to recovery of renal function was analyzed.SPSS 18.0 software was used for statistical analysis.Results:1.All 33 patients showed acute kidney injury and none of the patients died.A total of 25 cases of drug-related ATIN accounted for75.8%of all ATIN,including 16 cases of drug-induced ATIN in the renal function recovery group,accounting for 84.2%of all patients with renal function recovery,and 9 cases of patients without renal function recovery.64.2%of the recovery group.There were 14 patients with ATIN due to taking antibiotics,accounting for 56.0%of drug-related ATIN,and 7patients with non-steroidal anti-inflammatory drugs?NSAIDs?,2 patients took proton pump inhibitors?PPIs?.In addition,infection-related ATIN and unexplained ATIN accounted for 12.1%of all ATIN.2.After 3 months of follow-up treatment,the patients were divided into renal function recovery group and unrecovered group according to the eGFR level.It was found that patients with a history of previous hypertension with unrecovered renal function were significantly more than those in the recovery group.The difference was statistically significant?P<0.05?.The eGFR and urinary?₂-microglobulin??₂-M?levels in patients with renal function recovery group were significantly higher than those in the unrecovered group,and the difference was statistically significant?P<0.05?.3.Through logistic multivariate regression analysis,hypertension was found to be an independent factor affecting poor renal function recovery,and?₂-M and pre-treatment eGFR levels had no effect on renal function.Conclusion:1.Drugs were the main cause of ATIN,most of them caused by antibiotics,and some patients also caused ATIN due to drugs such as NSAIDs and PPIs.2.It was found that patients with a history of previous hypertension with renal function unrecovered group were significantly more than those with recovery group.The eGFR and urine?₂-M levels in patients with renal function recovery group were significantly higher than those in unrecovered group.3.The overall prognosis of ATIN is good,and the presence of hypertension in patients may be an independent risk factor affecting the recovery of renal function.