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논문 기본 정보

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저자정보
Kim Hyunseo (Division of Nephrology Department of Internal Medicine Korea University Anam Hospital Korea Univers) 조상경 (고려대학교) Ahn Shin Young (Division of Nephrology Department of Internal Medicine Korea University Guro Hospital Korea Univers) Kwon Young Joo (Division of Nephrology Department of Internal Medicine Korea University Guro Hospital Korea Univers) 이하정 (서울대학교병원) 오지은 (한림대학교) Chin Ho Jun (Division of Nephrology Department of Internal Medicine Seoul National University Bundang Hospital S) Lim Kijoon (Division of Nephrology Department of Internal Medicine Korea University Anam Hospital Korea Univers) Lee Junyong (Division of Nephrology Department of Internal Medicine Korea University Anam Hospital Korea Univers) Yang Jihyun (Division of Nephrology Department of Internal Medicine Korea University Anam Hospital Korea Univers) Kim Myung-Gyu (Division of Nephrology Department of Internal Medicine Korea University Anam Hospital Korea Univers) Cho Won Yong (Division of Nephrology Department of Internal Medicine Korea University Anam Hospital Korea Univers) 오세원 (고려대학교)
저널정보
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.35 No.26
발행연도
2020.1
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1 - 10 (10page)

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Background: Although emerging evidence suggest acute kidney injury (AKI) progress to chronic kidney disease (CKD), long-term renal outcome of AKI still remains unclear. Acute tubular necrosis (ATN) is the most common cause of AKI due to ischemia, toxin or sepsis. Acute interstitial nephritis (AIN), caused by drugs or autoimmune diseases is also increasingly recognized as an important cause of AKI. Unlike glomerular diseases, AKI is usually diagnosed in the clinical context without kidney biopsies, and lack of histology might contribute to this uncertainty. Methods: Among 8,769 biopsy series, 253 adults who were histologically diagnosed with ATN and AIN from 1982 to 2018 at five university hospitals were included. Demographic and pathological features that are associated with the development of end stage renal disease (ESRD) were also examined. Results: Rate of non-recovery of renal function at 6 month was significantly higher in the AIN (ATN vs AIN 49.3 vs 69.4%, P = 0.007) with a 2.71-fold higher risk of non- recovery compared to ATN (95% confidence interval [CI], 1.20–6.47). During the mean follow up of 76.5 ± 91.9 months, ESRD developed in 39.4% of patients with AIN, and 21.5% patients of ATN. The risk of ESRD was significantly higher in AIN (23.05; 95% CI, 2.42–219.53) and also in ATN (12.14; 95% CI, 1.19–24.24) compared to control with non-specific pathology. Older age, female gender, renal function at the time of biopsy and at 6 months, proteinuria and pathological features including interstitial inflammation and fibrosis, tubulitis, vascular lesion were significantly associated with progression to ESRD. Conclusion: Our study demonstrated that patients with biopsy proven ATN and AIN are at high risk of developing ESRD. AIN showed higher rate of non-renal recovery at 6 month than ATN.
#Acute Interstitial Nephritis #Acute Tubular Necrosis #Inflammation #Fibrosis

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참고문헌 (16)

참고문헌 신청
Coca SG / 2012 / Chronic kidney disease after acute kidney injury : a systematic review and meta-analysis / Kidney Int 81(5):442~448 google schola Heung M / 2016 / Acute kidney injury recovery pattern and subsequent risk of CKD : an analysis of veterans health administration data / Am J Kidney Dis 67(5):742~752 google schola Foley RN / 2015 / End-stage renal disease attributed to acute tubular necrosis in the United States, 2001–2010 / Am J Nephrol 41(1):1~6 google schola Rosen S / 2008 / Acute tubular necrosis is a syndrome of physiologic and pathologic dissociation / J Am Soc Nephrol 19(5):871~875 google schola Praga M / 2010 / Acute interstitial nephritis / Kidney Int 77(11):956~961 google schola

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