University of Oulu

Rytkönen, S., Tainio, J., Saarela, V. et al. Long-term outcome of biopsy-proven idiopathic tubulointersitial nephritis with or without uveitis in children—a nationwide follow-up study. Pediatr Nephrol 36, 3663–3671 (2021).

Long-term outcome of biopsy-proven idiopathic tubulointersitial nephritis with or without uveitis in children : a nationwide follow-up study

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Author: Rytkönen, Sari1,2; Tainio, Juuso3; Saarela, Ville4;
Organizations: 1Department of Children and Adolescents and PEDEGO Research Unit, Oulu University, Oulu, Finland
2Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland
3Department of Paediatric Nephrology and Transplantation, New Children’s Hospital, University of Helsinki and Helsinki University Hospital, Box 347, Stenbäckinkatu 9, 00029, Helsinki, HUS, Finland
4Department of Ophthalmology, Oulu University Hospital, Oulu, Finland
5Department of Paediatrics, Tampere University Hospital, Tampere, Finland
6Department of Paediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland
7Department of Paediatrics, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
Persistent link:
Language: English
Published: Springer Nature, 2021
Publish Date: 2021-11-10


Background: Only a few studies reporting the long-term outcome of children with idiopathic tubulointerstitial nephritis (TIN) and uveitis syndrome (TINU) are available. We studied the long-term kidney and ocular outcome in a nationwide cohort of children with TIN or TINU.

Methods: All patients followed up for a minimum of 1 year by a paediatrician and an ophthalmologist were enrolled. The data on plasma creatinine (P-Cr), estimated glomerular filtration rate (eGFR), proteinuria, hypertension and uveitis were collected retrospectively.

Results: Fifty-two patients were studied. Median age at time of diagnosis was 13.1 (1.8–16.9) years and median follow-up time was 5.7 (1.1–21.2) years. Forty-five (87%) patients were initially treated with glucocorticoids. The median of the maximum P-Cr was 162 μmol/l (47–1,016) and that of eGFR 47 ml/min/1.73m² (8–124). Uveitis was diagnosed in 33 patients (63%) and 21 (40%) patients developed chronic uveitis. P-Cr normalised in a median of 2 months. Eleven (21%) patients had nephritis recurrence during or after discontinuation of glucocorticoids. At the latest follow-up, 13 (25%) patients had eGFR < 90 ml/min/1.73m² (median 83; 61–89 ml/min/1.73m²). Six patients had tubular proteinuria; all presented with TIN without uveitis. Seven (13%) patients were hypertensive. Eleven (21%) patients had uveitis. One patient developed uraemia and was later transplanted.

Conclusions: Our study questions the previously reported good long-term kidney and ocular outcome of patients with TIN/TINU. Decreased kidney function and/or ocular co-morbidities may persist for several years; thus, both kidney and ocular follow-up for at least 1 year is warranted.

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Series: Pediatric nephrology
ISSN: 0931-041X
ISSN-E: 1432-198X
ISSN-L: 0931-041X
Volume: 36
Issue: 11
Pages: 3663 - 3671
DOI: 10.1007/s00467-021-05060-5
Type of Publication: A1 Journal article – refereed
Field of Science: 3125 Otorhinolaryngology, ophthalmology
Funding: Open access funding provided by University of Helsinki including Helsinki University Central Hospital. This work was supported by a grant to SR and TJ from the Foundation for Paediatric Research, the Päivikki and Sakari Sohlberg Foundation, and the Alma and K.A. Snellman Foundation, Oulu, Finland.
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