The spectrum of biopsy-proven kidney diseases, causes, and renal outcomes in acute kidney injury patients

This study analyzed the pathological disease spectrum, causes, and renal outcomes of biopsied AKI patients. Methods: We retrospectively included 2,027 AKI patients who underwent kidney biopsies at a national clinical research center of kidney diseases from 2013 through 2018. To compare the biopsied AKI cases without and with coexisting glomerulopathy, patients were classified into acute tubular/tubulointerstitial nephropathy-associated AKI (ATIN-AKI) and glomerular disease-associated AKI (GD-AKI) groups. Results: Of 2,027 biopsied AKI patients, 65.1% were male, with a median age of 43 years. A total of 1,590 (78.4%) patients had coexisting GD, while only 437 (21.6%) patients had ATIN alone. The AKI patients with GD mainly (53.5%) manifested as stage 1 AKI, while most ATIN-AKI patients (74.8%) had stage 3 AKI. In the ATIN-AKI group, 256 (58.6%) patients had acute interstitial nephritis (AIN), and 77 (17.6%) had acute tubular injury (ATI). ATIN-AKI was mainly caused by drugs in 85.5% of AIN and 63.6% of ATI cases, respectively. In AKI patients with coexisting GD, the leading pathological diagnoses in over 80% of patients were IgA nephropathy (IgAN,22.5%), minimal change disease (MCD,17.5%), focal segmental glomerulosclerosis (FSGS,15.3%), lupus nephritis (LN,11.9%), membranous nephropathy (MN,10.2%), and ANCA-associated vasculitis (AAV,4.7%). A total of 775 patients followed up within 3 months after renal biopsy; ATIN-AKI patients achieved statistically higher complete ren...
Source: Nephron - Category: Urology & Nephrology Source Type: research