Abstract
Background: Primary Tubulointerstitial Nephritis (TIN) is inflammation of predominantly tubular & interstitial compartment without involving glomeruli and vessels, which may be due to varied etiologies. Drugs are the most common culprit for Primary TIN worldwide. Here we studied a series of primary TIN in renal biopsies at a tertiary care center. Methods: In this retrospective study of ten year duration, we have studied all cases of primary TIN with history of drug intake. We reviewed these cases for symptoms, etiology and histomorphological features. Results: A total of 54 cases of primary TIN were described. The age range of the patients was 6 to 72 years with mean of 47.8 years. Pedal edema, puffiness of face were the most common symptoms followed by oliguria. Non-Steroidal Anti-Inflammatory (NSAIDs) were found to be the most common group of drugs causing acute TIN resulting in acute kidney injury (AKI). These are followed by antibiotics and ayurvedic/indigenous preparations. Acute TIN was more commonly seen histopathology than chronic TIN. Conclusion: NSAIDs are most common cause of TIN followed by ayurvedic drugs. Timely diagnosis and withdrawal of offending agent with prompt treatment may help to preserve or improve renal function.
Highlights
The term ‘Tubulointerstitial Nephritis (TIN)’ connotes to inflammatory changes seen predominantly in interstitium & tubules
Primary TIN is referred to a condition where inflammation is limited to tubulointerstitial compartment without involving glomeruli and vessels.[1]
It is difficult to estimate exact prevalence of TIN, acute TIN is seen in 0.5-3% of kidney biopsies and seen as prominent finding in 5-27% of kidney biopsies performed for acute kidney injury.[2,3,4]
Summary
The term ‘Tubulointerstitial Nephritis (TIN)’ connotes to inflammatory changes seen predominantly in interstitium & tubules. Primary TIN is referred to a condition where inflammation is limited to tubulointerstitial compartment without involving glomeruli and vessels.[1] It is difficult to estimate exact prevalence of TIN, acute TIN is seen in 0.5-3% of kidney biopsies and seen as prominent finding in 5-27% of kidney biopsies performed for acute kidney injury.[2,3,4]. Infections were the most common etiological agents for TIN, after the development of antibiotics, rate of infections decreased and antibiotics emerged as predominant cause. In last two to three decades, NSAIDs was the leading cause for drug induced TIN.[2]. Primary Tubulointerstitial Nephritis (TIN) is inflammation of predominantly tubular & interstitial compartment without involving glomeruli and vessels, which may be due to varied etiologies. Drugs are the most common culprit for Primary TIN worldwide. We studied a series of primary TIN in renal biopsies at a tertiary care center
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