Clinical outcome and occurrence of uveitis in children with idiopathic tubulointerstitial nephritis |
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Authors: | Timo Jahnukainen Marja Ala-Houhala Riitta Karikoski Janne Kataja Ville Saarela Matti Nuutinen |
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Institution: | (1) Department of Pediatric Nephrology and Transplantation, Hospital for Children and Adolescents, University of Helsinki, Stenb?ckinkatu 11, Box 281, 00029 Helsinki, Finland;(2) Department of Pediatrics, Tampere University Hospital, Tampere, Finland;(3) Department of Pathology, Helsinki University Hospital, Helsinki, Finland;(4) Department of Pediatrics, Turku University Hospital, Turku, Finland;(5) Department of Ophthalmology, Oulu University Hospital, Oulu, Finland;(6) Department of Pediatrics and Adolescence, Oulu University Hospital, Oulu, Finland |
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Abstract: | Acute idiopathic tubulointerstitial nephritis (TIN) is considered a condition with a good long-term prognosis. However, there
is evidence that some patients develop permanent renal impairment. The aim of this study was to evaluate the clinical characteristics
of TIN at the time of diagnosis in children and determine whether the findings upon presentation predict renal outcome. The
clinical data and biopsy findings from 26 children with idiopathic TIN admitted to four Finnish university hospitals were
analyzed retrospectively. Twenty-five patients (96%) manifested renal insufficiency. After the mean follow-up time of 2.75 years
(SD 2.5; 0.9–13.5), 4 patients (15%) had permanent renal insufficiency and 8 patients (31%) had persistent low-molecular weight
proteinuria. Uveitis was found in 12 patients (46%). Four of these patients (33%) developed chronic uveitis. Our analysis
showed that none of the laboratory or biopsy findings upon presentation prognosticated renal outcome. No correlation between
renal disease and uveitis could be found either. The occurrence of uveitis among TIN patients was higher than previously reported.
Uveitis may develop late and without recurrence of renal dysfunction. Therefore, follow-up by a pediatrician and by an ophthalmologist
is warranted in children with acute TIN for at least 12 months from diagnosis. |
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