ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: SA-PO538

Long Term Outcomes of Acute Tubular Necrosis and Acute Tubulointerstitial Nephritis

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Oh, Sewon, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea (the Republic of)
  • Lee, Junyong, Korea University Anam Hospital, Seongbuk-Gu, Seoul, Korea (the Republic of)
  • Yang, Jihyun, Korea universtiy Anam hospital, Seoul, Korea (the Republic of)
  • Kim, Myung-Gyu, National Institutes of Health, Bethesda, Maryland, United States
  • Jo, Sang-Kyung, Korea University Hospital, Seoul, Korea (the Republic of)
Background

Renal damage of acute tubular necrosis (ATN) and acute tubulointerstitial nephritis (ATIN) are considered reversible. However, the prevalence and long-term outcome of ATN and ATIN were unknown.

Methods

We included 4690 adult patients who had underwent kidney biopsy in two tertiary hospital in Korea during 1979-2017. We excluded patients with biopsy confirmed end stage renal disease (ESRD), previous kidney transplantation, malignancy, and inadequate biopsy specimen.

Results

Mean age was 39.0±15.5 years and 55% was male. Primary glomerulonephritis (PGN) was 3466 (65.4%), secondary glomerulonephritis (SGN) was 1088 (20.5%), and ATN or ATIN was 136 (2.6%). Patients with ATN or ATIN were significantly older compared than PGN or SGN (P<0.001) and had lower eGFR (P<0.001; 31.9±28.0, 74.5±36.6, and 70.9±38.5ml/min/1.73m2, respectively). Mortality was the highest in patients with SGN (18.0%). Mortality in patients with PGN was 8.7%, and ATN or ATIN was 7.4% (P<0.001). The incidence of ESRD was much lower in patients with ATN or ATIN (2.9%) compared than PGN (14.4%) or SGN (15.0%) (P=0.001). During 156.8 ± 101.8 months follow up period, the adjusted risk of mortality was higher in patients with SGN compared than PGN (RR 2.156; 95% CI, 1.795-2.590). However, risk of mortality was not significantly different between PGN and ATN or ATIN. The adjusted risk of ESRD was significantly lower in patients with ATN or ATIN (RR 0.100; 95% CI, 0.037-0.268) compared than PGN, and the risks of ESRD was not different between PGN and SGN during 155.3±105.8 months.

Conclusion

The risk of long-term mortality was not different between PGN and ATN or ATIN. Although the risk of ESRD was significantly lower in patients with ATN or ATIN compared than GN, 2.9% of ATN or ATIN patients progressed to ESRD.