A Systematic Review of Treatment for Acute Interstitial Nephritis
Introduction: Acute interstitial nephritis (AIN) is a common cause of acute kidney injury. It is characterized by tubular inflammation with eosinophils histologically. The mainstay treatment for AIN includes early diagnosis; underlying infection or systemic disease treatment; cessation of the offend...
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Elsevier
2025-08-01
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| Series: | Kidney International Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468024925002967 |
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| author | Yalin Yu Erik Biros Xiao Chang Andrew J. Mallett |
| author_facet | Yalin Yu Erik Biros Xiao Chang Andrew J. Mallett |
| author_sort | Yalin Yu |
| collection | DOAJ |
| description | Introduction: Acute interstitial nephritis (AIN) is a common cause of acute kidney injury. It is characterized by tubular inflammation with eosinophils histologically. The mainstay treatment for AIN includes early diagnosis; underlying infection or systemic disease treatment; cessation of the offending agent; and corticosteroid therapy, when indicated. This systematic review aims to evaluate the efficacy and safety of pharmacotherapy treatments for AIN by assessing treatment outcomes and adverse effects. Methods: PubMed, Embase, Cochrane Library, and other major databases were systematically searched in June 2024 after registration with the International Prospective Register of Systematic Reviews. Manual searches of the references in relevant articles were conducted. Studies focusing on the treatment of AIN cases that were diagnosed histologically were included. A fixed-effects meta-analysis and meta-regression were performed using Stata SE 16. Results: A total of 3597 articles were eligible for screening. Twenty-three articles were included in the systematic review. There were 3 randomized controlled trials, 4 case series, and 16 retrospective cohort studies. Corticosteroids were the primary treatment in most of the studies, with 1 study evaluating the use of mycophenolate mofetil (MMF) in steroid-refractory patients. A meta-analysis of 3 studies showed that prednisolone use improved renal outcomes. There was significant variability across studies in dosing, treatment duration, and timing of initiation. Adverse events associated with corticosteroids were likely underreported. Conclusion: Consistent evidence supporting the use of corticosteroids for treating AIN needs to be more comprehensive. There needs to be a clear consensus on the optimal treatment regimen. High-quality randomized controlled trials are required to help establish evidence-based guidelines for treating AIN. |
| format | Article |
| id | doaj-art-d4327b5f1bd54e69bebc74a145c17f74 |
| institution | DOAJ |
| issn | 2468-0249 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
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| series | Kidney International Reports |
| spelling | doaj-art-d4327b5f1bd54e69bebc74a145c17f742025-08-20T03:16:00ZengElsevierKidney International Reports2468-02492025-08-011082575258410.1016/j.ekir.2025.05.009A Systematic Review of Treatment for Acute Interstitial NephritisYalin Yu0Erik Biros1Xiao Chang2Andrew J. Mallett3Townsville Institute of Health Research and Innovation, Townsville University Hospital, Douglas, Queensland, AustraliaCollege of Medicine and Dentistry, James Cook University, Douglas, Queensland, AustraliaTownsville Institute of Health Research and Innovation, Townsville University Hospital, Douglas, Queensland, AustraliaTownsville Institute of Health Research and Innovation, Townsville University Hospital, Douglas, Queensland, Australia; Department of Renal Medicine, Townsville University Hospital, Douglas, Queensland, Australia; College of Medicine and Dentistry, James Cook University, Douglas, Queensland, Australia; Institute for Molecular Bioscience, The University of Queensland, St Lucia, Queensland, Australia; Correspondence: Andrew Mallett, Department of Renal Medicine, Townsville University Hospital, Douglas, Queensland 4029, Australia.Introduction: Acute interstitial nephritis (AIN) is a common cause of acute kidney injury. It is characterized by tubular inflammation with eosinophils histologically. The mainstay treatment for AIN includes early diagnosis; underlying infection or systemic disease treatment; cessation of the offending agent; and corticosteroid therapy, when indicated. This systematic review aims to evaluate the efficacy and safety of pharmacotherapy treatments for AIN by assessing treatment outcomes and adverse effects. Methods: PubMed, Embase, Cochrane Library, and other major databases were systematically searched in June 2024 after registration with the International Prospective Register of Systematic Reviews. Manual searches of the references in relevant articles were conducted. Studies focusing on the treatment of AIN cases that were diagnosed histologically were included. A fixed-effects meta-analysis and meta-regression were performed using Stata SE 16. Results: A total of 3597 articles were eligible for screening. Twenty-three articles were included in the systematic review. There were 3 randomized controlled trials, 4 case series, and 16 retrospective cohort studies. Corticosteroids were the primary treatment in most of the studies, with 1 study evaluating the use of mycophenolate mofetil (MMF) in steroid-refractory patients. A meta-analysis of 3 studies showed that prednisolone use improved renal outcomes. There was significant variability across studies in dosing, treatment duration, and timing of initiation. Adverse events associated with corticosteroids were likely underreported. Conclusion: Consistent evidence supporting the use of corticosteroids for treating AIN needs to be more comprehensive. There needs to be a clear consensus on the optimal treatment regimen. High-quality randomized controlled trials are required to help establish evidence-based guidelines for treating AIN.http://www.sciencedirect.com/science/article/pii/S2468024925002967acute interstitial nephritiscorticosteroidmeta-analysisrenal outcomesystematic reviewtreatment |
| spellingShingle | Yalin Yu Erik Biros Xiao Chang Andrew J. Mallett A Systematic Review of Treatment for Acute Interstitial Nephritis Kidney International Reports acute interstitial nephritis corticosteroid meta-analysis renal outcome systematic review treatment |
| title | A Systematic Review of Treatment for Acute Interstitial Nephritis |
| title_full | A Systematic Review of Treatment for Acute Interstitial Nephritis |
| title_fullStr | A Systematic Review of Treatment for Acute Interstitial Nephritis |
| title_full_unstemmed | A Systematic Review of Treatment for Acute Interstitial Nephritis |
| title_short | A Systematic Review of Treatment for Acute Interstitial Nephritis |
| title_sort | systematic review of treatment for acute interstitial nephritis |
| topic | acute interstitial nephritis corticosteroid meta-analysis renal outcome systematic review treatment |
| url | http://www.sciencedirect.com/science/article/pii/S2468024925002967 |
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