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Clinical outcome and occurrence of uveitis in children with idiopathic tubulointerstitial nephritis

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Abstract

Acute idiopathic tubulointerstitial nephritis (TIN) is considered a condition with a good long-term prognosis. However, there is evidence that some patients develop permanent renal impairment. The aim of this study was to evaluate the clinical characteristics of TIN at the time of diagnosis in children and determine whether the findings upon presentation predict renal outcome. The clinical data and biopsy findings from 26 children with idiopathic TIN admitted to four Finnish university hospitals were analyzed retrospectively. Twenty-five patients (96%) manifested renal insufficiency. After the mean follow-up time of 2.75 years (SD 2.5; 0.9–13.5), 4 patients (15%) had permanent renal insufficiency and 8 patients (31%) had persistent low-molecular weight proteinuria. Uveitis was found in 12 patients (46%). Four of these patients (33%) developed chronic uveitis. Our analysis showed that none of the laboratory or biopsy findings upon presentation prognosticated renal outcome. No correlation between renal disease and uveitis could be found either. The occurrence of uveitis among TIN patients was higher than previously reported. Uveitis may develop late and without recurrence of renal dysfunction. Therefore, follow-up by a pediatrician and by an ophthalmologist is warranted in children with acute TIN for at least 12 months from diagnosis.

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Acknowledgement

Work was supported by the Foundation for Paediatric Research, Finland.

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Authors and Affiliations

  1. Department of Pediatric Nephrology and Transplantation, Hospital for Children and Adolescents, University of Helsinki, Stenbäckinkatu 11, Box 281, 00029, Helsinki, Finland

    Timo Jahnukainen

  2. Department of Pediatrics, Tampere University Hospital, Tampere, Finland

    Marja Ala-Houhala

  3. Department of Pathology, Helsinki University Hospital, Helsinki, Finland

    Riitta Karikoski

  4. Department of Pediatrics, Turku University Hospital, Turku, Finland

    Janne Kataja

  5. Department of Ophthalmology, Oulu University Hospital, Oulu, Finland

    Ville Saarela

  6. Department of Pediatrics and Adolescence, Oulu University Hospital, Oulu, Finland

    Matti Nuutinen

Authors
  1. Timo Jahnukainen
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  2. Marja Ala-Houhala
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  3. Riitta Karikoski
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  4. Janne Kataja
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  5. Ville Saarela
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  6. Matti Nuutinen
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Correspondence to Timo Jahnukainen.

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Jahnukainen, T., Ala-Houhala, M., Karikoski, R. et al. Clinical outcome and occurrence of uveitis in children with idiopathic tubulointerstitial nephritis. Pediatr Nephrol 26, 291–299 (2011). https://doi.org/10.1007/s00467-010-1698-4

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  • DOI: https://doi.org/10.1007/s00467-010-1698-4

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