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Prednisone in the treatment of tubulointerstitial nephritis in children

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Abstract

Background

Patients with tubulointerstitial nephritis (TIN) may develop permanent renal impairment. However, there are no prospective studies available on the treatment of TIN.

Methods

The effect of prednisone in the treatment of TIN was evaluated in a total of 17 patients who received prednisone or who were followed up without medication. The patient group was subdivided based on the initial plasma creatinine (PCr), below or above 150 μmol/l.

Results

All prednisone-treated patients had normal plasma creatinine (PCr) after 1 month of treatment (median 59.1 [45–85] μmol/l) whereas only 50 % of patients in the non-treatment group had normal creatinine (median 81.0 [42–123] μmol/l) at the same time point (p = 0.025). During 6 months’ follow-up, PCr decreased in all patient groups; however, it decreased significantly only in prednisone-treated patients with baseline PCr >150 μmol/l (p < 0.001). At the end of follow-up, no difference in PCr, glomerular filtration rate (GFR), or low molecular weight (LMW) proteinuria could be found between the study groups. A considerable number of patients in both groups had subnormal GFR and/or persistent LMW proteinuria at the 6-month follow-up visit. Eighty-two percent of the patients had uveitis.

Conclusions

Prednisone speeds up the recovery from renal symptoms of TIN, especially in patients with severe nephritis. The renal function did not differ significantly between prednisone and control patients after 6 months’ follow-up.

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Acknowledgements

The work was supported by the Foundation for Paediatric Research, Finland.

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Authors and Affiliations

  1. Department of Paediatric Nephrology and Transplantation, Children’s Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland

    Timo Jahnukainen, Elisa Ylinen & Kai Rönnholm

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

    Ville Saarela

  3. Department of Paediatrics, Kuopio University Hospital, Kuopio, Finland

    Pekka Arikoski

  4. Department of Paediatrics, Tampere University Hospital, Tampere, Finland

    Marja Ala-Houhala

  5. Department of Paediatrics and Adolescence, Oulu University Hospital, Oulu, Finland

    Matti Nuutinen

  6. Children’s Hospital, Stenbäckinkatu 11, Box 281, 00029, Helsinki, Finland

    Timo Jahnukainen

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  1. Timo Jahnukainen
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  2. Ville Saarela
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  6. Marja Ala-Houhala
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  7. Matti Nuutinen
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Correspondence to Timo Jahnukainen.

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Jahnukainen, T., Saarela, V., Arikoski, P. et al. Prednisone in the treatment of tubulointerstitial nephritis in children. Pediatr Nephrol 28, 1253–1260 (2013). https://doi.org/10.1007/s00467-013-2476-x

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  • DOI: https://doi.org/10.1007/s00467-013-2476-x

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