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Ramachandran R, Kumar K, Nada R, et al. Drug-induced acute interstitial nephritis: A clinicopathological study and comparative trial of steroid regimens. Indian J Nephrol. 2015;25(5):281-6doi: 10.4103/0971-4065.147766.
Ramachandran, R., Kumar, K., Nada, R., Jha, V., Gupta, K. L., & Kohli, H. S. (2015). Drug-induced acute interstitial nephritis: A clinicopathological study and comparative trial of steroid regimens. Indian journal of nephrology, 25(5), 281-6. https://doi.org/10.4103/0971-4065.147766
Ramachandran, R, et al. "Drug-induced acute interstitial nephritis: A clinicopathological study and comparative trial of steroid regimens." Indian journal of nephrology vol. 25,5 (2015): 281-6. doi: https://doi.org/10.4103/0971-4065.147766
Ramachandran R, Kumar K, Nada R, Jha V, Gupta KL, Kohli HS. Drug-induced acute interstitial nephritis: A clinicopathological study and comparative trial of steroid regimens. Indian J Nephrol. 2015 Sep-Oct;25(5):281-6. doi: 10.4103/0971-4065.147766. PMID: 26628793; PMCID: PMC4588323.
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Indian J Nephrol. 2015 Sep-Oct;25(5):281-6. doi: 10.4103/0971-4065.147766.

Drug-induced acute interstitial nephritis: A clinicopathological study and comparative trial of steroid regimens.

Indian journal of nephrology

R Ramachandran, K Kumar, R Nada, V Jha, K L Gupta, H S Kohli

Affiliations

  1. Department of Nephrology, PGIMER, Chandigarh, India.
  2. Department of Histopathology, PGIMER, Chandigarh, India.

PMID: 26628793 PMCID: PMC4588323 DOI: 10.4103/0971-4065.147766

Abstract

Steroids are used in the management of drug-induced acute interstitial nephritis (AIN). The present study was undertaken to compare the efficacy of pulse methyl prednisolone with oral prednisolone in the treatment of drug-induced AIN. Patients with biopsy-proven AIN with a history of drug intake were randomized to oral prednisolone (Group 1) 1 mg/kg for 3 weeks or a pulse methyl prednisolone (Group II) 30 mg/kg for 3 days followed by oral prednisolone 1 mg/kg for 2 weeks, tapered over 3 weeks. Kidney biopsy scoring was done for interstitial edema, infiltration and tubular damage. The response was reported as complete remission (CR) (improvement in estimated glomerular filtration rate [eGFR] to ≥60 ml/min/1.73 m(2)), partial remission (PR) (improvement but eGFR <60 ml/min/1.73 m(2)) or resistance (no CR/PR). A total of 29 patients, Group I: 16 and Group II: 13 were studied. Offending drugs included nonsteroidal anti-inflammatory drugs, herbal drugs, antibiotics, diuretic, rifampicin and omeprazole. There was no difference in the baseline parameters between the two groups. The biopsy score in Groups I and II was 5.9 ± 1.1 and 5.1 ± 1.2, respectively. At 3 months in Group I, eight patients each (50%) achieved CR and PR. In Group II, 8 (61%) achieved CR and 5 (39%) PR. This was not significantly different. Percentage fall in serum creatinine at 1 week (56%) was higher in CR as compared to (42%) those with PR. (P = 0.14). Patients with neutrophil infiltration had higher CR compared to patients with no neutrophil infiltration (P = 0.01). Early steroid therapy, both oral and pulse steroid, is equally effective in achieving remission in drug-induced AIN.

Keywords: Acute interstitial nephritis; estimated glomerular filtration rate; nonsteroidal anti-inflammatory drugs

References

  1. Clin J Am Soc Nephrol. 2013 Nov;8(11):1857-62 - PubMed
  2. Kidney Int. 2010 Jun;77(11):956-61 - PubMed
  3. Clin Nephrol. 2000 Sep;54(3):179-90 - PubMed
  4. Kidney Int. 2008 Apr;73(8):940-6 - PubMed
  5. Am J Kidney Dis. 2014 Oct;64(4):558-66 - PubMed
  6. Nephrol Dial Transplant. 2004 Nov;19(11):2778-83 - PubMed
  7. Am Fam Physician. 2003 Jun 15;67(12 ):2527-34 - PubMed
  8. Nephrol Dial Transplant. 2004 Jan;19(1):8-11 - PubMed

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