1
|
Usefulness of gallium-67 scintigraphy for evaluating the histopathological activity in interstitial nephritis. Clin Exp Nephrol 2023; 27:251-261. [PMID: 36574102 DOI: 10.1007/s10157-022-02302-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 11/21/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Interstitial nephritis is a common cause of renal failure. Gallium-67 scintigraphy is reportedly useful for diagnosing interstitial nephritis; however, its ability to assess disease activity remains unknown. We aimed to analyze the relationship between the renal uptake of gallium-67 and the disease activity in interstitial nephritis. METHODS We retrospectively analyzed the data of patients who underwent gallium-67 scintigraphy at a hospital in Tokyo. The renal uptake adjusted for the soft tissues beneath the kidneys was semi-quantitatively evaluated. We compared the renal uptake levels between patients clinically diagnosed with and without interstitial nephritis. Among those undergoing renal biopsy, we evaluated the predictive ability of gallium-67 scintigraphy and analyzed the renal uptake levels regarding the disease activity through a histopathological analysis. RESULTS We included 143 patients; among them, 30, 17, and 96 patients were clinically diagnosed with interstitial nephritis, other kidney diseases, and non-kidney diseases, respectively. The renal uptake of gallium-67 was the highest among patients with interstitial nephritis. Among the 25 patients who underwent renal biopsy, 15 were pathologically diagnosed with interstitial nephritis. The renal uptake levels showed a high discriminative ability (C-statistic: 0.83). Furthermore, net reclassification improvement with the addition of gallium-67 scintigraphy to N-acetyl-β-D-glucosaminidase for the prediction of interstitial nephritis was 1.14. Histopathological analysis revealed a positive correlation between renal uptake and inflammation in the cortex and peritubular capillaries. CONCLUSIONS This study confirmed the diagnostic value and potential usefulness of gallium-67 scintigraphy for evaluating interstitial nephritis.
Collapse
|
2
|
Hadded S, Harzallah A, Chargui S, Hajji M, Kaaroud H, Goucha R, Ben Hamida F, Gorsane I, Ben Abdallah T. [Etiologies and prognostic factors of acute interstitial nephritis]. Nephrol Ther 2021; 17:114-119. [PMID: 33485789 DOI: 10.1016/j.nephro.2020.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 10/21/2020] [Accepted: 10/26/2020] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Acute interstitial nephritis represents a clinically and etiologically heterogeneous group of kidney diseases. The aim of our study was to explore the main causes of biopsy-proven acute interstitial nephritis and to identify predictive factors of renal outcome. METHODS We conducted a retrospective monocentric study which included patients with biopsy proven AIN, followed in our department during the period between 1980 and 2018. The non-recovery of kidney function or an estimated glomerular filtration rate˂60 mL/min/1.73 m2 were considered as a worse renal outcome. RESULTS A total of 65 acute interstitial nephritis patients were enrolled. The mean age of patients was 41.3±16 years with a female predominance (78%). Drug-induced etiology was the most common (29%). The most frequent culprit drugs in our study were NSAID followed by antibiotics. The renal prognosis was unfavorable in 21 cases (32%). The independent predictive factors for renal outcome were : a percentage of sclerotic glomeruli greater than 15% (P=0.004), absence of interstitial edema (P˂0.001), non-use to corticosteroid therapy (P=0.02) and a delay in initiating corticosteroid therapy greater than 21 days (P=0.02). CONCLUSION Drugs currently represent the most common cause of acute interstitial nephritis. The renal prognosis is often favorable, but the progression can be towards chronic renal failure in the event of diagnostic and therapeutic delay. Our data suggest a beneficial influence of steroids on the outcome of acute interstitial nephritis.
Collapse
Affiliation(s)
- Sarra Hadded
- Service de médecine A, hôpital Charles-Nicolle-de-Tunis, boulevard du 9-avril-1938, 1007 Tunis, Bab Saâdoun, Tunisie; Faculté de médecine de Tunis, université de Tunis-El-Manar, 1007 Tunis, Tunisie.
| | - Amel Harzallah
- Service de médecine A, hôpital Charles-Nicolle-de-Tunis, boulevard du 9-avril-1938, 1007 Tunis, Bab Saâdoun, Tunisie; Laboratoire de pathologie rénale LR00SP01, hôpital Charles-Nicolle-de-Tunis, boulevard du 9 avril 1938, 1007 Tunis, Bab Saâdoun, Tunisie; Faculté de médecine de Tunis, université de Tunis-El-Manar, 1007 Tunis, Tunisie
| | - Soumaya Chargui
- Service de médecine A, hôpital Charles-Nicolle-de-Tunis, boulevard du 9-avril-1938, 1007 Tunis, Bab Saâdoun, Tunisie; Laboratoire de pathologie rénale LR00SP01, hôpital Charles-Nicolle-de-Tunis, boulevard du 9 avril 1938, 1007 Tunis, Bab Saâdoun, Tunisie; Faculté de médecine de Tunis, université de Tunis-El-Manar, 1007 Tunis, Tunisie
| | - Mariem Hajji
- Service de médecine A, hôpital Charles-Nicolle-de-Tunis, boulevard du 9-avril-1938, 1007 Tunis, Bab Saâdoun, Tunisie; Laboratoire de pathologie rénale LR00SP01, hôpital Charles-Nicolle-de-Tunis, boulevard du 9 avril 1938, 1007 Tunis, Bab Saâdoun, Tunisie; Faculté de médecine de Tunis, université de Tunis-El-Manar, 1007 Tunis, Tunisie
| | - Hayet Kaaroud
- Service de médecine A, hôpital Charles-Nicolle-de-Tunis, boulevard du 9-avril-1938, 1007 Tunis, Bab Saâdoun, Tunisie; Laboratoire de pathologie rénale LR00SP01, hôpital Charles-Nicolle-de-Tunis, boulevard du 9 avril 1938, 1007 Tunis, Bab Saâdoun, Tunisie; Faculté de médecine de Tunis, université de Tunis-El-Manar, 1007 Tunis, Tunisie
| | - Rim Goucha
- Service de médecine A, hôpital Charles-Nicolle-de-Tunis, boulevard du 9-avril-1938, 1007 Tunis, Bab Saâdoun, Tunisie; Laboratoire de pathologie rénale LR00SP01, hôpital Charles-Nicolle-de-Tunis, boulevard du 9 avril 1938, 1007 Tunis, Bab Saâdoun, Tunisie; Faculté de médecine de Tunis, université de Tunis-El-Manar, 1007 Tunis, Tunisie
| | - Fathi Ben Hamida
- Service de médecine A, hôpital Charles-Nicolle-de-Tunis, boulevard du 9-avril-1938, 1007 Tunis, Bab Saâdoun, Tunisie; Laboratoire de pathologie rénale LR00SP01, hôpital Charles-Nicolle-de-Tunis, boulevard du 9 avril 1938, 1007 Tunis, Bab Saâdoun, Tunisie; Faculté de médecine de Tunis, université de Tunis-El-Manar, 1007 Tunis, Tunisie
| | - Imen Gorsane
- Service de médecine A, hôpital Charles-Nicolle-de-Tunis, boulevard du 9-avril-1938, 1007 Tunis, Bab Saâdoun, Tunisie; Faculté de médecine de Tunis, université de Tunis-El-Manar, 1007 Tunis, Tunisie
| | - Taieb Ben Abdallah
- Service de médecine A, hôpital Charles-Nicolle-de-Tunis, boulevard du 9-avril-1938, 1007 Tunis, Bab Saâdoun, Tunisie; Faculté de médecine de Tunis, université de Tunis-El-Manar, 1007 Tunis, Tunisie
| |
Collapse
|