Prognosis

Most patients with medication-related acute interstitial nephritis (AIN) will have significant impairment of kidney function after an episode of AIN.[1][11]​ About 40% to 60% of patients have chronic kidney disease (glomerular filtration rate <60 mL/minute) after AIN, some of whom will require chronic renal replacement therapy.​[41]​​ Tubulointerstitial fibrosis on biopsy remains a long-term consequence of AIN, and a higher degree of fibrosis is associated with a lower rate of kidney function recovery after AIN.[11] Delay in diagnosis, longer exposure to triggering drugs, and delay in initiation of corticosteroids are also associated with worse recovery of kidney function.[3][42]

In patients prescribed immune checkpoint inhibitors, similar to other immune related adverse events, immune checkpoint inhibitor-related AIN is associated with lower mortality at 1 year than immune checkpoint inhibitor-unrelated acute kideney disease. AIN may be a marker of immune checkpoint inhibitor therapy efficacy in these patients.[43]

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