Nefropatías tubulointersticiales no obstructivas biopsiadas en Uruguay

Introduction

Interstitial nephropathies include a wide spectrum of acute and chronic renal diseases. The aims of this study were to evaluate frequency, clinical onset, histological damage, treatment and outcomes of patients with non-obstructive tubulointerstitial nephropathies (TIN) in Uruguay (defined by clinical diagnosis and/or renal biopsy).

Methods

A retrospective analysis was performed on the complete clinical records of 124 patients. They were classified into two groups: Group 1: 66 patients with a clinical diagnosis of TIN and chronic kidney disease from the Uruguayan Renal Healthcare Program (PSR), and Group 2: 58 patients from the national Registry of Kidney biopsies (RUG/RUB).

Results

In both cohorts, being female doubled the risk of TIN vs men (OR 2.3 in the PSR and 1.9 in the RUB, P<.05), mainly due to by drugs. The most frequent clinical presentation in the biopsied group was as acute renal failure/rapidly progressive renal failure (Table 1). A higher degree of interstitial infiltration of inflammatory cells was associated with more frequent steroid treatment (OR 6.3, 95% CI; 1.6–24.3, P<.05). In the steroid-treated group, a lower level of interstitial fibrosis was associated with glomerular filtration rate improvement (OR 0.143, 95% CI; 0.028-0.720, P<.05)

Conclusions

The results were similar to those found in international reports on the clinical presentation of TIN, and highlight the importance of renal histology in treatment decisions and to predict outcomes.