Kidney Week

Abstract: SA-PO538

Long Term Outcomes of Acute Tubular Necrosis and Acute Tubulointerstitial Nephritis

Session Information

• AKI: Clinical, Outcomes, Trials - II
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

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)

Sewon Oh,

• Lee, Junyong, Korea University Anam Hospital, Seongbuk-Gu, Seoul, Korea (the Republic of)

Junyong Lee,

• Yang, Jihyun, Korea universtiy Anam hospital, Seoul, Korea (the Republic of)

Jihyun Yang,

• Kim, Myung-Gyu, National Institutes of Health, Bethesda, Maryland, United States

Myung-Gyu Kim,

• Jo, Sang-Kyung, Korea University Hospital, Seoul, Korea (the Republic of)

Sang-Kyung Jo,

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.