A1 Refereed original research article in a scientific journal
Long-term outcome of biopsy-proven idiopathic tubulointersitial nephritis with or without uveitis in children-a nationwide follow-up study
Authors: Rytkönen Sari, Tainio Juuso, Saarela Ville, Endén Kira, Kataja Janne, Arikoski Pekka, Nuutinen Matti, Jahnukainen Timo
Publisher: SPRINGER
Publication year: 2021
Journal: Pediatric Nephrology
Journal acronym: PEDIATR NEPHROL
Number of pages: 9
ISSN: 0931-041X
eISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-021-05060-5
Web address : https://link.springer.com/article/10.1007/s00467-021-05060-5
Self-archived copy’s web address: https://research.utu.fi/converis/portal/Publication/58941795
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 mu mol/l (47-1,016) and that of eGFR 47 ml/min/1.73m(2) (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(2) (median 83; 61-89 ml/min/1.73m(2)). 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.
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