Norihito Moniwa1,2, Marenao Tanaka3, Hiroshi Sato4, Akira Shimizu5, Hitoshi Sugiyama6, Hitoshi Yokoyama7, Kazuhiko Tsuruya8, Akinori Hashiguchi9. 1. Department of Nephrology, Teine Keijinkai Hospital, 1-40, 1 jo 12 chome Maeda, Teine-ku, Sapporo, 006-8555, Japan. moniwa@sapmed.ac.jp. 2. Department of Cardiology, Nephrology and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan. moniwa@sapmed.ac.jp. 3. Department of Cardiology, Nephrology and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan. 4. Deparment of Internal Medicine, Sendai Hospital of East Japan Railway Company, Sendai, Japan. 5. Department of Analytic Human Pathology, Nippon Medical School, Tokyo, Japan. 6. Department of Medicine, Kawasaki Medical School General Medical Center and Department of Medical Care Work, Kawasaki College of Allied Health Professions, Okayama, Japan. 7. Department of Nephrology, Kanazawa Medical University, Uchinada, Japan. 8. Department of Nephrology, Nara Medical University, Kashihara, Japan. 9. Department of Pathology, Keio University School of Medicine, Tokyo, Japan.
Abstract
INTRODUCTION: Acute kidney injury (AKI) is a worldwide concern and it leads to a poor prognosis or end-stage kidney disease. The purpose of this study was to clarify the characteristics of patients with AKI in whom kidney biopsy was performed using data of the Japan Renal Biopsy Registry (J-RBR). METHODS: We screened 38,351 cases that were registered in the J-RBR from 2007 to 2018. We obtained data for 383 patients with AKI based on clinical diagnosis for analysis 1 and data for 714 patients with acute interstitial nephritis (AIN) or acute tubular necrosis (ATN) based on pathological diagnosis for analysis 2. RESULTS: Of the cases screened, 383 patients with AKI (1.0%) were included in analysis 1. The main pathological diagnoses of AKI were AIN, ATN, chronic interstitial nephritis, nephro-sclerosis and crescentic glomerulonephritis. Of the cases screened, 589 patients with AIN (1.5%) and 110 patients with ATN (0.3%) were included in analysis 2. The main clinical diagnoses of AIN were AKI, rapidly progressive glomerulonephritis (RPGN), chronic nephritic syndrome (CNS) and drug-induced nephropathy (DIN), whereas those of ATN were AKI, RPGN, DIN and CNS. ATN patients had a higher serum creatinine level than that of AIN patients. CONCLUSION: Our results revealed that cases in the J-RBR included 1.0% of AKI cases based on clinical diagnosis and 1.5% and 0.3% of AIN and ATN cases, respectively, based on pathological diagnosis. In patients with suspected intrinsic AKI, kidney biopsy should be performed for diagnosis of the precise etiology and selection of appropriate treatment.
INTRODUCTION: Acute kidney injury (AKI) is a worldwide concern and it leads to a poor prognosis or end-stage kidney disease. The purpose of this study was to clarify the characteristics of patients with AKI in whom kidney biopsy was performed using data of the Japan Renal Biopsy Registry (J-RBR). METHODS: We screened 38,351 cases that were registered in the J-RBR from 2007 to 2018. We obtained data for 383 patients with AKI based on clinical diagnosis for analysis 1 and data for 714 patients with acute interstitial nephritis (AIN) or acute tubular necrosis (ATN) based on pathological diagnosis for analysis 2. RESULTS: Of the cases screened, 383 patients with AKI (1.0%) were included in analysis 1. The main pathological diagnoses of AKI were AIN, ATN, chronic interstitial nephritis, nephro-sclerosis and crescentic glomerulonephritis. Of the cases screened, 589 patients with AIN (1.5%) and 110 patients with ATN (0.3%) were included in analysis 2. The main clinical diagnoses of AIN were AKI, rapidly progressive glomerulonephritis (RPGN), chronic nephritic syndrome (CNS) and drug-induced nephropathy (DIN), whereas those of ATN were AKI, RPGN, DIN and CNS. ATN patients had a higher serum creatinine level than that of AIN patients. CONCLUSION: Our results revealed that cases in the J-RBR included 1.0% of AKI cases based on clinical diagnosis and 1.5% and 0.3% of AIN and ATN cases, respectively, based on pathological diagnosis. In patients with suspected intrinsic AKI, kidney biopsy should be performed for diagnosis of the precise etiology and selection of appropriate treatment.
Authors: Maria Prendecki; Anisha Tanna; Alan D Salama; Frederick W K Tam; Tom Cairns; David Taube; H Terence Cook; Damien Ashby; Neil D Duncan; Charles D Pusey Journal: Clin Kidney J Date: 2016-12-24