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BMC Nephrology, 2019. 20(1), 88-, DOI: https://doi.org/10.1186/s12882-019-1277-2
Effect of steroids and relevant cytokine analysis in acute tubulointersittial nephritis
Donghwan Yun, Myoung-jin Jang;Jung Nam An;Jung Pyo Lee;Dong Ki Kim;Ho Jun Chin;Yon Su Kim;Dong-Sup Lee;Seung Seok Han
Background: Acute tubulointerstitial nephritis (ATIN) is an important cause of acute kidney injury and often apotentially reversible disease. However, the role of steroids in ATIN remains controversial and the underlyingmechanisms remain unresolved.
Methods: A total of 113 adult patients with biopsy-proven ATIN were recruited from three tertiary referral centers.Of 102 patients with idiopathic or drug-induced ATIN, outcomes such as renal recovery, end-stage renal disease,and all-cause mortality were compared between the steroid-treated and non-treated groups. Plasma and urineinflammatory cytokine levels at the time of biopsy were analyzed in patients (n = 33) using a bead-based multiplexassay and compared with those of healthy individuals (n = 40).
Results: Steroids were used in 92 (81.4%) of the total patients and in 82 (80.3%) patients with idiopathic or druginducedATIN. The rate of renal recovery and the risks of end-stage renal disease and mortality were not differentbetween the steroid-treated and non-treated groups. Despite using a propensity score matching method (n = 20 ineach group), none of the outcomes were different between the two groups. Several cytokines, such as monocytechemotactic protein-1, interferon-α, and interleukin-6 and interleukin-8 levels, were markedly elevated in plasmaand urine of patients compared with those in healthy individuals. However, cytokines related to Th2 response, suchas IL-10, IL-33, were not different between the two groups.
Conclusions: Steroid use does not affect the overall outcome of ATIN. Based on the fact that targeting therapyshould be investigated to improve outcomes, the present cytokine results will be helpful for developing a noveltherapy for ATIN.
- DOI: https://doi.org/10.1186/s12882-019-1277-2
- ISBN or ISSN: 1471-2369
- 본 연구는 질병관리본부 연구개발과제연구비를 지원받아 수행되었습니다.
- This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention.