{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T16:54:27Z","timestamp":1768409667334,"version":"3.49.0"},"reference-count":52,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2019,8,4]],"date-time":"2019-08-04T00:00:00Z","timestamp":1564876800000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Acute interstitial nephritis (AIN) is a renal injury causing renal function deterioration and requiring renal replacement therapy (RRT) in a substantial number of cases. Therapy is based on withdrawal of suspicious causative drugs or the underlying diseases and\/or steroid application if renal function is not restored after cessation of the underlying condition. Hard clinical evidence for augmenting steroid therapy is not available.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed the course and diagnosis for &amp;gt;20\u2009years among all 1126 biopsied samples of our tertiary renal centre.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>49 (4.4%) were diagnosed with primary AIN, corresponding to an annual incidence of 1\/100\u00a0000 population; 17 out of 49 biopsy-proven AIN patients required short-term or long-term (n\u2009=\u20095) RRT. According to a combined outcome criterion of coming off dialysis and\/or reaching serum creatinine &amp;lt;200\u2009\u00b5mol\/L, 19 patients reached recovery whereas 20 did not. Among 39 patients with a comprehensive clinical and histopathological data set, presence of cortical scars, AIN histological activity (acute leucocyte infiltrates) and proteinuria were baseline parameters discriminating significantly between groups with or without recovery. No associations with the presence of specific drugs were found. Therapeutic use of steroids was associated with a lower probability of recovery (P\u2009=\u20090.008), presumably due to inclusion bias.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Following our basic finding of the importance of histopathological parameters of acuity associated with recovery, we argue for the inauguration of grading measures to characterize this issue quantitatively and make it usable for future controlled investigations. Finally, we provide a suggestion for a therapeutic algorithm in the management of AIN.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ckj\/sfz097","type":"journal-article","created":{"date-parts":[[2019,7,12]],"date-time":"2019-07-12T11:15:16Z","timestamp":1562930116000},"page":"814-820","source":"Crossref","is-referenced-by-count":8,"title":["Inflammatory leucocyte infiltrates are associated with recovery in biopsy-proven acute interstitial nephritis: a 20-year registry-based case series"],"prefix":"10.1093","volume":"12","author":[{"given":"Ralph","family":"Wendt","sequence":"first","affiliation":[{"name":"Division of Nephrology and Kuratorium for Dialysis and Transplantation (KfH) Renal Unit, Hospital St Georg, Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Schliecker","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Kuratorium for Dialysis and Transplantation (KfH) Renal Unit, Hospital St Georg, Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joachim","family":"Beige","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Kuratorium for Dialysis and Transplantation (KfH) Renal Unit, Hospital St Georg, Leipzig, Germany"},{"name":"Department of Internal Medicine II, Division of Nephrology and Rheumatology, Martin-Luther-University Halle\/Wittenberg, Halle (Saale), Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,8,3]]},"reference":[{"key":"2020021105432227900_sfz097-B1","doi-asserted-by":"crossref","first-page":"97","DOI":"10.3109\/08860229609052779","article-title":"Evaluation of clinical and histological prognostic markers in drug-induced acute interstitial nephritis","volume":"18","author":"Bhaumik","year":"1996","journal-title":"Ren Fail"},{"key":"2020021105432227900_sfz097-B2","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1093\/ndt\/5.2.94","article-title":"Acute interstitial nephritis: a clinical and morphological study in 27 patients","volume":"5","author":"Buysen","year":"1990","journal-title":"Nephrol Dial Transplant"},{"key":"2020021105432227900_sfz097-B3","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1002\/pds.3329","article-title":"Proton pump inhibitors and traditional nonsteroidal anti-inflammatory drugs and the risk of acute interstitial nephritis and acute kidney injury","volume":"21","author":"Leonard","year":"2012","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"2020021105432227900_sfz097-B4","doi-asserted-by":"crossref","first-page":"809","DOI":"10.3109\/08860229809045178","article-title":"Drug-induced acute interstitial nephritis","volume":"20","author":"Alexopoulos","year":"1998","journal-title":"Ren Fail"},{"key":"2020021105432227900_sfz097-B5","doi-asserted-by":"crossref","first-page":"735","DOI":"10.7326\/0003-4819-93-5-735","article-title":"Acute interstitial nephritis due to drugs: review","volume":"93","author":"Linton","year":"1980","journal-title":"Ann Intern Med"},{"key":"2020021105432227900_sfz097-B6","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1055\/s-2008-1069641","article-title":"Acute interstitial nephritis caused by drugs]","volume":"108","author":"Pommer","year":"2008","journal-title":"Dtsch Med Wochenschr"},{"key":"2020021105432227900_sfz097-B7","first-page":"151","article-title":"A decade of penicillin related acute interstitial nephritis\u2013more questions than answers","volume":"13","author":"Appel","year":"1980","journal-title":"Clin Nephrol"},{"key":"2020021105432227900_sfz097-B8","doi-asserted-by":"crossref","first-page":"2940","DOI":"10.1093\/ndt\/gfp277","article-title":"A case of sulphasalazine-induced DRESS syndrome with delayed acute interstitial nephritis","volume":"24","author":"Augusto","year":"2009","journal-title":"Nephrol Dial Transplant"},{"key":"2020021105432227900_sfz097-B9","doi-asserted-by":"crossref","first-page":"5975","DOI":"10.1073\/pnas.77.10.5975","article-title":"Regulation of insulin receptors: evidence for involvement of an endocytotic internalization pathway","volume":"77","author":"Baldwin","year":"1980","journal-title":"Proc Natl Acad Sci USA"},{"key":"2020021105432227900_sfz097-B10","first-page":"731284","article-title":"Sildenafil induced acute interstitial nephritis","volume":"2015","author":"Burkhart","year":"2015","journal-title":"Case Rep Nephrol"},{"key":"2020021105432227900_sfz097-B11","first-page":"265","article-title":"Mesalazine-associated tubulo-interstitial nephritis in inflammatory bowel disease","volume":"49","author":"Calvino","year":"1998","journal-title":"Clin Nephrol"},{"key":"2020021105432227900_sfz097-B12","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/1471-2369-11-19","article-title":"Biopsy proven acute interstitial nephritis after treatment with moxifloxacin","volume":"11","author":"Chatzikyrkou","year":"2010","journal-title":"BMC Nephrol"},{"key":"2020021105432227900_sfz097-B13","first-page":"390","article-title":"Interstitial nephritis related to nonsteroidal anti-inflammatory agents and beta-lactam antibiotics: a comparative study of the interstitial infiltrates using monoclonal antibodies","volume":"2","author":"D\u2019Agati","year":"1989","journal-title":"Mod Pathol"},{"key":"2020021105432227900_sfz097-B14","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1016\/j.cgh.2005.11.004","article-title":"Proton pump inhibitors and acute interstitial nephritis","volume":"4","author":"Geevasinga","year":"2006","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2020021105432227900_sfz097-B15","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1001\/archinte.1983.00350040201031","article-title":"Cimetidine-induced interstitial nephritis with response to prednisone therapy","volume":"143","author":"Kaye","year":"1983","journal-title":"Arch Intern Med"},{"key":"2020021105432227900_sfz097-B16","doi-asserted-by":"crossref","first-page":"e369","DOI":"10.1016\/j.lpm.2014.03.032","article-title":"Prospective study of drug-induced interstitial nephritis in eleven French nephrology units","volume":"43","author":"Leven","year":"2014","journal-title":"Presse Med"},{"key":"2020021105432227900_sfz097-B17","first-page":"252","article-title":"Acute interstitial nephritis following treatment with anorectic agents phentermine and phendimetrazine","volume":"50","author":"Markowitz","year":"1998","journal-title":"Clin Nephrol"},{"key":"2020021105432227900_sfz097-B18","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1002\/j.1875-9114.1992.tb04490.x","article-title":"Review of drug-induced acute interstitial nephritis","volume":"12","author":"Murray","year":"1992","journal-title":"Pharmacotherapy"},{"key":"2020021105432227900_sfz097-B19","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1038\/nrneph.2010.71","article-title":"Drug-induced acute interstitial nephritis","volume":"6","author":"Perazella","year":"2010","journal-title":"Nat Rev Nephrol"},{"key":"2020021105432227900_sfz097-B20","first-page":"169","article-title":"Cimetidine-induced acute interstitial nephritis","volume":"77","author":"Pitone","year":"1982","journal-title":"Am J Gastroenterol"},{"key":"2020021105432227900_sfz097-B21","doi-asserted-by":"crossref","first-page":"304","DOI":"10.4103\/0971-4065.114487","article-title":"Acute interstitial nephritis due to proton pump inhibitors","volume":"23","author":"Sampathkumar","year":"2013","journal-title":"Indian J Nephrol"},{"key":"2020021105432227900_sfz097-B22","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1111\/j.1365-2036.2007.03407.x","article-title":"Systematic review: proton pump inhibitor-associated acute interstitial nephritis","volume":"26","author":"Sierra","year":"2007","journal-title":"Aliment Pharmacol Ther"},{"key":"2020021105432227900_sfz097-B23","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1159\/000167970","article-title":"Captopril-associated acute interstitial nephritis","volume":"9","author":"Smith","year":"1989","journal-title":"Am J Nephrol"},{"key":"2020021105432227900_sfz097-B24","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1097\/01.inf.0000141753.41486.ff","article-title":"Recurrent acute interstitial nephritis induced by azithromycin","volume":"23","author":"Soni","year":"2004","journal-title":"Pediatr Infect Dis J"},{"key":"2020021105432227900_sfz097-B25","doi-asserted-by":"crossref","first-page":"65","DOI":"10.5694\/j.1326-5377.1975.tb111234.x","article-title":"Acute interstitial nephritis following ampicillin hypersensitivity","volume":"1","author":"Woodroffe","year":"1975","journal-title":"Med J Aust"},{"key":"2020021105432227900_sfz097-B26","doi-asserted-by":"crossref","first-page":"31","DOI":"10.5414\/CNCS109221","article-title":"Successful recovery of associated interstitial nephritis and focal segmental glomerulosclerosis in patients with HCV and HIV treated with sofosbuvir and daclatasvir and revision of literature","volume":"6","author":"Mirabella","year":"2018","journal-title":"Clin Nephrol Case Stud"},{"key":"2020021105432227900_sfz097-B27","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1159\/000168871","article-title":"Clinical and immune aspects of idiopathic acute tubulointerstitial nephritis and uveitis syndrome","volume":"15","author":"Rodriguez-Perez","year":"1995","journal-title":"Am J Nephrol"},{"key":"2020021105432227900_sfz097-B28","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1159\/000184012","article-title":"Tubulointerstitial disease in lupus nephritis: relationship to immune deposits, interstitial inflammation, glomerular changes, renal function, and prognosis","volume":"44","author":"Park","year":"1986","journal-title":"Nephron"},{"key":"2020021105432227900_sfz097-B29","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/s12016-016-8533-z","article-title":"Molecular and immunological basis of tubulo-interstitial injury in lupus nephritis: a comprehensive review","volume":"52","author":"Yung","year":"2017","journal-title":"Clin Rev Allergy Immunol"},{"key":"2020021105432227900_sfz097-B30","first-page":"219","article-title":"Granulomatous interstitial nephritis","volume":"13","author":"Mignon","year":"1984","journal-title":"Adv Nephrol Necker Hosp"},{"key":"2020021105432227900_sfz097-B31","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1111\/j.1365-2125.2007.02927.x","article-title":"Proton pump inhibitor-induced acute interstitial nephritis","volume":"64","author":"Harmark","year":"2007","journal-title":"Br J Clin Pharmacol"},{"key":"2020021105432227900_sfz097-B32","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1111\/j.1440-1797.2006.00651.x","article-title":"Proton pump inhibitors and acute interstitial nephritis: report and analysis of 15 cases","volume":"11","author":"Simpson","year":"2006","journal-title":"Nephrology (Carlton)"},{"key":"2020021105432227900_sfz097-B33","doi-asserted-by":"crossref","first-page":"3153","DOI":"10.1681\/ASN.2015121377","article-title":"Proton pump inhibitors and risk of incident CKD and progression to ESRD","volume":"27","author":"Xie","year":"2016","journal-title":"J Am Soc Nephrol"},{"key":"2020021105432227900_sfz097-B34","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1093\/ndt\/gfg464","article-title":"The changing profile of acute tubulointerstitial nephritis","volume":"19","author":"Baker","year":"2004","journal-title":"Nephrol Dial Transplant"},{"key":"2020021105432227900_sfz097-B35","doi-asserted-by":"crossref","first-page":"381","DOI":"10.5414\/CN108301","article-title":"Diagnosing drug-induced AIN in the hospitalized patient: a challenge for the clinician","volume":"81","author":"Perazella","year":"2014","journal-title":"Clin Nephrol"},{"key":"2020021105432227900_sfz097-B36","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1038\/ki.2014.294","article-title":"Clinical characteristics, causes and outcomes of acute interstitial nephritis in the elderly","volume":"87","author":"Muriithi","year":"2015","journal-title":"Kidney Int"},{"key":"2020021105432227900_sfz097-B37","doi-asserted-by":"crossref","first-page":"1851","DOI":"10.2215\/CJN.01390118","article-title":"Duration of treatment with corticosteroids and recovery of kidney function in acute interstitial nephritis","volume":"13","author":"Fernandez-Juarez","year":"2018","journal-title":"Clin J Am Soc Nephrol"},{"key":"2020021105432227900_sfz097-B38","first-page":"233","article-title":"Long-term outcome in biopsy-proven acute interstitial nephritis treated with steroids","volume":"10","author":"Prendecki","year":"2017","journal-title":"Clin Kidney J"},{"key":"2020021105432227900_sfz097-B39","doi-asserted-by":"crossref","first-page":"69","DOI":"10.3109\/08860229309065575","article-title":"Acute renal failure in patients with drug-induced acute interstitial nephritis","volume":"15","author":"Koselj","year":"1993","journal-title":"Ren Fail"},{"key":"2020021105432227900_sfz097-B40","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1093\/qjmed\/hcu236","article-title":"Acute tubulointerstitial nephritis in Scotland","volume":"108","author":"Valluri","year":"2015","journal-title":"QJM"},{"key":"2020021105432227900_sfz097-B41","first-page":"179","article-title":"The outcome of acute interstitial nephritis: risk factors for the transition from acute to chronic interstitial nephritis","volume":"54","author":"Schwarz","year":"2000","journal-title":"Clin Nephrol"},{"key":"2020021105432227900_sfz097-B42","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1186\/1471-2369-14-150","article-title":"Proton pump inhibitors and acute kidney injury: a nested case-control study","volume":"14","author":"Klepser","year":"2013","journal-title":"BMC Nephrol"},{"key":"2020021105432227900_sfz097-B43","doi-asserted-by":"crossref","first-page":"3408","DOI":"10.1002\/art.20583","article-title":"Glucocorticoids in the treatment of rheumatic diseases: an update on the mechanisms of action","volume":"50","author":"Buttgereit","year":"2004","journal-title":"Arthritis Rheum"},{"key":"2020021105432227900_sfz097-B44","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1111\/j.1365-2249.1996.tb08306.x","article-title":"Prednisone increases apoptosis in in vitro activated human peripheral blood T lymphocytes","volume":"103","author":"Lanza","year":"2007","journal-title":"Clin Exp Immunol"},{"key":"2020021105432227900_sfz097-B45","doi-asserted-by":"crossref","first-page":"3866","DOI":"10.1210\/en.2002-220188","article-title":"Dexamethasone and tumor necrosis factor-alpha act together to induce the cellular inhibitor of apoptosis-2 gene and prevent apoptosis in a variety of cell types","volume":"143","author":"Webster","year":"2002","journal-title":"Endocrinology"},{"key":"2020021105432227900_sfz097-B46","doi-asserted-by":"crossref","first-page":"1716","DOI":"10.1093\/ndt\/gfp751","article-title":"Effect of corticosteroids during ongoing drug exposure in pantoprazole-induced interstitial nephritis","volume":"25","author":"Kim","year":"2010","journal-title":"Nephrol Dial Transplant"},{"key":"2020021105432227900_sfz097-B47","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1038\/sj.ki.5002776","article-title":"Early steroid treatment improves the recovery of renal function in patients with drug-induced acute interstitial nephritis","volume":"73","author":"Gonz\u00e1lez","year":"2008","journal-title":"Kidney Int"},{"key":"2020021105432227900_sfz097-B48","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.2215\/CJN.02150212","article-title":"of Percutaneous kidney biopsies in 715 children and 8573 adults in Norway 1988\u20132010","volume":"7","author":"T\u00f8ndel","year":"2012","journal-title":"Clin J Am Soc Nephrol"},{"key":"2020021105432227900_sfz097-B49","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1053\/j.ajkd.2012.02.330","article-title":"Bleeding complications of native kidney biopsy: a systematic review and meta-analysis","volume":"60","author":"Corapi","year":"2012","journal-title":"Am J Kidney Dis"},{"key":"2020021105432227900_sfz097-B50","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1093\/ckj\/sfy048","article-title":"Risk of percutaneous renal biopsy of native kidneys in the evaluation of acute kidney injury","volume":"11","author":"Korbet","year":"2018","journal-title":"Clin Kidney J"},{"key":"2020021105432227900_sfz097-B51","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1093\/ckj\/sfx012","article-title":"Risk factors for bleeding complications after nephrologist-performed native renal biopsy","volume":"10","author":"Lees","year":"2017","journal-title":"Clin Kidney J"},{"key":"2020021105432227900_sfz097-B52","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1093\/ckj\/sfy075","article-title":"Renal biopsy: it is time for pragmatism and consensus","volume":"11","author":"Lees","year":"2018","journal-title":"Clin Kidney J"}],"container-title":["Clinical Kidney Journal"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ckj\/article-pdf\/12\/6\/814\/32429794\/sfz097.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ckj\/article-pdf\/12\/6\/814\/32429794\/sfz097.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,20]],"date-time":"2024-07-20T22:39:12Z","timestamp":1721515152000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ckj\/article\/12\/6\/814\/5543477"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,3]]},"references-count":52,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2019,8,3]]},"published-print":{"date-parts":[[2019,12,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ckj\/sfz097","relation":{},"ISSN":["2048-8505","2048-8513"],"issn-type":[{"value":"2048-8505","type":"print"},{"value":"2048-8513","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2019,12]]},"published":{"date-parts":[[2019,8,3]]}}}