Abstract: TH-PO0072
Clinical and Histological Predictors of Kidney Function After Acute Tubulointerstitial Nephritis
Session Information
- AKI: Pathogenesis and Disease Mechanisms
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Koval, Emma L, Yale School of Medicine Department of Internal Medicine, New Haven, Connecticut, United States
- Liang, Cathleen G, Yale School of Medicine Department of Internal Medicine, New Haven, Connecticut, United States
- Sadarangani, Sagar S., Yale School of Medicine Department of Internal Medicine, New Haven, Connecticut, United States
- Shelton, Kyra A., Yale School of Medicine Department of Internal Medicine, New Haven, Connecticut, United States
- Kent, Candice, Yale School of Medicine Department of Internal Medicine, New Haven, Connecticut, United States
- Shaw, Melissa M., Yale School of Medicine Department of Internal Medicine, New Haven, Connecticut, United States
- Wilson, Francis Perry, Yale School of Medicine Department of Internal Medicine, New Haven, Connecticut, United States
- Moledina, Dennis G., Yale School of Medicine Department of Internal Medicine, New Haven, Connecticut, United States
Background
While most patients lose some degree of kidney function after an episode of acute tubulointerstitial nephritis (ATIN), there is wide variability in recovery. Understanding predictors of recovery at the time of diagnosis could guide treatment and provide evidence-based prognosis. Here, we test the association of various clinical and histological features with kidney function 6 months after ATIN.
Methods
We included a cohort of participants with biopsy-proven ATIN enrolled between 2020-2025. We tested for association of 16 total clinical and histological predictors (Figure 1) with the outcome of eGFR measured at 6 (+/-3) months after diagnosis (6m eGFR). We used LASSO with Bayesian Information Criterion (BIC) optimization to build a multivariable model of 6m eGFR.
Results
Of the 134 participants included, eGFR was lower by a median of 18.6 (interquartile range, 5.5, 37.9) at 6 months than at pre-ATIN baseline. Five out of 16 features were associated with 6m eGFR in univariable analysis (Figure 1) of which 2 (baseline eGFR and IFTA) were selected by LASSO for multivariable analysis such that each 1 ml/min/1.73 m2 increase in baseline eGFR was associated with 0.56 (95% CI, 0.41, 0.71) increase in 6m eGFR and each 10% increase in IFTA with 0.97 (95% CI, 0.08, 1.86) decrease.
Conclusion
These findings indicate that baseline eGFR and IFTA on biopsy are key predictors for kidney function following ATIN diagnosis and provide clinicians with data to guide treatment decisions and provide prognosis.