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The following is a summary of “A Predicting Tool for Kidney Function Recovery after Drug-Induced Acute Interstitial Nephritis,” published in the February 2025issue of Nephrology by Caravaca-Fontán et al. 

Drug-induced acute interstitial nephritis (DI-AIN) causes acute kidney injury. Early drug withdrawal and corticosteroids are key treatments. 

Researchers conducted a retrospective study to develop and validate a nomogram predicting kidney function recovery at 6 months in DI-AIN.  

They conducted a multicenter, retrospective study across 13 nephrology departments, including biopsy-proven patients with DI-AIN treated with corticosteroids from 1996-2023. The dataset was randomly divided into training (n=164) and validation (n=60) sets. Least absolute shrinkage and selection operator regression identified predictors of complete recovery (creatinine increase <25%) or no recovery (serum creatinine ≥75% or dialysis). 

The results showed that 51 (31%) in the training set and 19 (32%) in the validation set achieved complete recovery at 6 months, while 33 (20%) and 8 (13%) showed no recovery. Clinical characteristics were balanced. The selected predictors were age (<65/≥65 years), gender, interstitial fibrosis, and time to corticosteroid initiation (<7/≥7 days). The nomogram, based on a multivariable logistic regression model, had an AUC of 0.79 (95% CI: 0.71–0.88). Bootstrap self-sampling (1,000 times) validated the model. The calibration plot showed predicted outcomes aligned with observations, and decision curve analysis confirmed clinical benefit. 

They developed and validated a nomogram to predict kidney recovery at 6 months in DI-AIN patients treated with corticosteroids. They showed its usefulness in estimating prognosis and optimizing corticosteroid therapy. 

Source: academic.oup.com/ndt/advance-article-abstract/doi/10.1093/ndt/gfaf037/8026878