Tubulointerstitial nephritis as a cause of acute renal insufficiency in children
Authors:
Ľ. Kováčiková ml.; M. Chocholová; Ľ. Podracká
Authors place of work:
Detská klinika LFUK a NÚDCH, Bratislava
Published in the journal:
Čes-slov Pediat 2018; 73 (7): 449-454.
Category:
Case Report
Summary
Tubulointerstitial nephritis (TIN) in children is a rare disease caused by multiple factors, the most commonly by drugs and/or infection. TIN is characterized by histologic findings of edema a and the presence of inflammatory cells in interstitium. Clinically, it manifests by various degree of renal dysfunction. In this article, we represent three cases of children aged between 10 and 16 years in whom non-oliguric acute renal failure occurred as a result of TIN.
The disease presented with nonspecific features including febrilities, tiredness, loss of appetite, vomiting, headache and abdominal pain. Laboratory tests showed raised of inflammatory markers and elevated serum creatinine 268–499 μmol/l and blood urea nitrogen 10.3–17.8 mmol/l. Urinary sediment was without specific findings. Twenty-four – hour urine test revealed proteinuria below 1 g/24 h, low glomerular filtration 17.4–23.4 ml/min and increased electrolyte excretion and decreased tubular reabsorption 86,4–92%. Ultrasonography showed difuse renal hyperechogenicity. In two patients renal biopsy was performed. In one case renal biopsy was not indicated because an etiology was recognized. Therapy included nephroprotective agents and also systemic corticoids in two patients. In all cases renal functions completely recovered within twelve months from the beginning of the disease. In one patient anterior uveitis was diagnosed following renal function recovery. Such condition is known as a TINU syndrome.
Conclusion:
Acute tubulointerstitial nephritis is an important cause of acute renal failure that manifests usually as a non-oliguric form. Elimination of evoking factor, nephroprotective therapy and eventually corticoids result in complete renal function recovery.
KEY WORDS
acute renal insufficiency, tubulointerstitial nephritis, uveitis
Zdroje
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Štítky
Neonatology Paediatrics General practitioner for children and adolescentsČlánok vyšiel v časopise
Czech-Slovak Pediatrics
2018 Číslo 7
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