Epidemiology

The true incidence of acute interstitial nephritis (AIN) is unknown. Definitive diagnosis requires a biopsy, which may not be performed due to subtle clinical presentation or risk factors for complications, and hence the incidence is underestimated.[4] One study found that AIN incidence was 3.2 per 10,000 person-years in users of proton-pump inhibitors.[5]

Best available estimates come from measuring the prevalence of AIN in kidney biopsy registries. In unselected biopsies, around 2% of cases have AIN, whereas in biopsies of acute kidney injury, the prevalence of AIN is up to 18%.[1][4][6]​ AIN is the cause of end stage kidney disease in 1% of patients.[7]

In one study, women were more likely to have nonsteroidal anti-inflammatory drug-associated AIN and immune-mediated AIN.[6] Drug-induced AIN is more common in older patients, with antibiotics, proton-pump inhibitors, and NSAIDs the most frequently implicated.[8][9]

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