A cross Sectional Study to Know the Profile Of Patients with Acute Interstitial Nephropathy Attending KLES Dr. Prabhakar Kore Hospital and Medical Research Centre

Abstract

Background and objectives ABSTRACT Acute interstitial nephropathy is associated with increased morbidity, direct and indirect health care costs. Incidence is increasing and no studies have been done in the present setting. The objectives of the present study were to study the clinical and laboratory profile and leading causes of acute interstitial nephropathy and correlation between histopthology and clinical outcome. Methodology The present study was conducted in Department of Medicine and Nephrology, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum on 26 patients suspected to have AIN on clinical grounds and proven by renal biopsy presenting during the period of January 2009 to December 2009. Percutaneous renal biopsy was performed in all the patients. Platelet count, prothrombin time, partial thromboplastin time and blood group were established before the procedure was undertaken. Results A total 150 biopsies were done during the study period of which 26 ( 17.33% ) had AIN. Males ( 69.23% ) outnumbered females ( 30.77% ) with male to female ratio of 2.25:1. Majority ( 50% ) had age between 45 to 60 years. The most common clinical presentation was oliguria ( 84.62% ) . Out of 26 cases majority ( 57.69% ) patients had serum creatinine levels >5.0 mg/dL. Mild to moderate changes were seen in each of 38.46% patients whereas in 23.08% cases significant tubulointerstitial changes were observed. In this study each of 42.30% IV patients had drug induced AIN and idiopathic. Infections were seen in 15.38%. Among the patients with drug induced AIN, NSAIDS was the predominant ( 72.72% ) cause whereas 27.27% were due to antibiotics. Interpretation and conclusion This study confirms that AIN remains an important cause of acute renal failure and that it is mainly drug-induced, with non-steroidal drugs being particularly implicated. Patients with diffuse ( significant ) histopathological tubulointerstitial changes had significantly increased serum creatinine levels causing delayed and incomplete recovery compared to patchy ( mild and moderate ) changes.