Background: The Australian Institute of Health and Welfareââ?¬â?¢s first report into acute kidney injury demonstrated a\nsignificant increase in the incidence of acute-tubulo interstitial nephritis, the ICD-10 code representing both acute\ninterstitial nephritis and pyelonephritis, in women aged less than 55 years. In contrast, recent case series have reported\nrising rates of drug induced acute interstitial nephritis predominantly among elderly patients. Due to several limitations\nwith the Australian Institute of Health and Welfare report, this new trend requires further investigation to determine if\nrates of acute interstitial nephritis are truly increasing among younger Australian women.\nMethods: Patients who underwent a renal biopsy at a single center from 2000 to 2015 were reviewed and those with\nbiopsy confirmed acute interstitial nephritis were selected. Cause of acute interstitial nephritis, patient demographics,\nco-morbidities and renal indices for these patients when available were recorded and compared.\nResults: Eight hundred ninety-eight patients who underwent renal biopsy from 2000 to 2015 were reviewed and 40\npatients were identified with biopsy confirmed acute interstitial nephritis. The rate of acute interstitial nephritis\nincreased significantly over the study period (4 patients/2.2% of biopsies performed in 2000ââ?¬â??03 vs. 19 patients/6.7% of\nall biopsies performed in 2012ââ?¬â??15; p = 0.002). There was a marked increase in the number of women with AIN in the\nlast four years of the study (2 patients and 2.1% of biopsies performed in women in 2000ââ?¬â??2003 compared with 13\npatients and 9.0% of biopsies performed in women in 2012ââ?¬â??2015). Immune mediated causes of acute interstitial\nnephritis and NSAID associated AIN were more common in women (9 females vs. 3 males), occurred more frequently\nin the last eight years of the study and predominantly in patients under 55 years of age.\nConclusions: Our study demonstrates a significant increase in the number of patients with biopsy confirmed AIN. Also,\nwe provide preliminary evidence in support of an increase in rates of younger women with immune mediated acute\ninterstitial nephritis. These results support the findings of the Australian Institute of Health and Welfare and suggest\nthat younger women may be at higher risk of immune mediated and NSAID associated acute interstitial nephritis.
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