Clinical and prognostic analysis of 199 children with acute interstitial nephritis

Abstract:

Objective：To analyze the clinical feature and treatment of acute interstitial nephritis（AIN），so as to enhance the knowledge of AIN. Methods：Clinical data，disease cause，clinical features，laboratory and nephritic pathological results，and treating outcome of 199 patients with AIN in our hospital from January，2010 to December，2017 were analyzed. Results：Among 199 patients，180 pa－tients were infection-induced AIN，with the most common of respiratory infections，following by digestive infection; with main etiology of virus infection，including EB virus，Coxsackie virus，respiratory syncytial virus and so on. And 125 patients were caused by drugs （all were post-infection administration），with the most common drugs of anti-inflammatory drugs（NSAIDS） and antibiotics. Almost all children had renal involvement，including edema，oliguria，hematuria，proteinuria and aseptic leukocyturia to different degrees. Besides，69 patients had acute renal insufficiency. Four patients underwent renal biopsy and results showed that the majority was tubulointerstitial lesions and the glomerulus and renal vessels were basically normal. All patients were treated with removal cause and symptomatic treatment after admission. A total of 46 patients were treated with blood purification because of acute renal failure（ARF） or poisoning and 6 of them were treated with combination of glucocorticoid，after which renal function and urine tests returned to nor－mal in the short term. Conclusion：The main cause inducing AIN in children is infection，among which viral infection takes the domi－nant position，followed by drugs. The main clinical manifestations is unexplained renal function decline and abnormal urine test，among which severe patients may have AFR. Timely diagnosis and cause remove are key to treatment. Blood purification and short-term glucocorticoid therapy are needed when necessary and most of them have a good prognosis.