Interstitial nephritis epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohsen Basiri M.D.

Overview

Interstitial nephritis accounts for 10-15% of kidney disease worldwide. Analgesic-induced nephritis is 5-6 times more common in women. The elderly have more severe disease and increased risk of permanent damage. Children exposed to lead poisoning are more likely to develop nephritis as young adult. TIN with uveitis is more common in adolescent female.

Epidemiology and Demographics

Incidence

  • In one study the incidence of TIN among asymptomatic patients, biopsied for either hematuria or proteinuria, was 0.7 per 100 000.[1]
  • However, in a series of 109 patients from a large centre, biopsied for unexplained renal impairment with normal sized kidneys, TIN accounted for 29 of 109 (27%) cases.[2]
  • Overally, tubulointerstitial nephritis accounts for 10-15% of kidney disease worldwide.

Prevalence

While the definitive diagnosis of TIN needs a kidney biopsy, then determination of prevalence of acute TIN are based on retrospective reviews of biopsy registries, with an overall average of 2.8%of the total biopsies. The incidence of acute TIN increases among biopsies done specifically to evaluate acute renal failure of unknown origin, with an overall average of 13.5%. [3]

  • The prevalence of ATIN has increased in recent years, especially in patients aged >65 years. This could be due to an increase in drug-associated ATIN, which would justify early renal biopsy to identify ATIN and reduce the probability of progression to chronic kidney disease. [4]

Age

  • Patients of all age groups may develop TIN.The elderly have more severe disease and increased risk of permanent damage
  • Children exposed to lead poisoning are more likely to develop nephritis as young adult.
  • TIN with uveitis is more common in adolescent female
  • Tubulointerstitial nephritis and uveitis (TINU) syndrome

Race

  • There is no racial predilection to TIN; whereas, lead nephropathy is more common in black people owing to socioeconomic factors.

Gender

  • Analgesic-induced nephritis is 5-6 times more common in women, attributed to women taking more analgesics than men.

Region

  •  In certain regions, such as the Balkans (ie, Yugoslavia, Bosnia, Croatia, Romania, Bulgaria), where endemic nephropathy is common, interstitial diseases may be more prevalent.[5]

Developed Countries

Developing Countries

References

  1. Pettersson E, von Bonsdorff M, Tornroth T, Lindholm H. Nephritis among young Finnish men. Clin Nephrol 1984; 22: 217–222
  2. Farrington K, Levison DA, Greenwood RN, Cattell WR, Baker LR. Renal biopsy in patients with unexplained renal impairment and normal kidney size. Q J Med 1989; 70: 221–233
  3. Rajeev Raghavan & Garabed Eknoyan (2014). "Acute interstitial nephritis - a reappraisal and update". Clinical nephrology. 82 (3): 149–162. PMID 25079860. Unknown parameter |month= ignored (help)
  4. Marian Goicoechea, Francisco Rivera & Juan M. Lopez-Gomez (2013). "Increased prevalence of acute tubulointerstitial nephritis". Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association. 28 (1): 112–115. doi:10.1093/ndt/gfs143. PMID 22759386. Unknown parameter |month= ignored (help)
  5. Wilfried Karmaus, Plamen Dimitrov, Valeri Simeonov, Svetla Tsolova & Vecihi Batuman (2009). "Offspring of parents with Balkan Endemic Nephropathy have higher C-reactive protein levels suggestive of inflammatory processes: a longitudinal study". BMC nephrology. 10: 10. doi:10.1186/1471-2369-10-10. PMID 19400955. Unknown parameter |month= ignored (help)

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