Treatment of Acute Interstitial Nephritis with Severe Interstitial Fibrosis and Tubular Atrophy (>50%–75%)
When biopsy findings show severe interstitial fibrosis and tubular atrophy affecting more than 50% to 75% of the kidney, the clinical context for managing acute interstitial nephritis changes substantially — and so does the therapeutic strategy.
Clinical scenario
Severe interstitial fibrosis and tubular atrophy of the kidney (>50% to 75%) is present. In this setting, the potential for meaningful renal recovery is significantly diminished.
Treatment direction
Management in this scenario is guided by a supportive approach directed at underlying conditions — rather than aggressive immunosuppression. The complete sequencing, specific interventions, and clinical decision points are detailed in the full protocol…
References
DOI: 10.1016/j.ekir.2025.03.050
In cases where severe interstitial fibrosis and tubular atrophy (>50% to 75%) are present, the potential for renal recovery is significantly diminished, rendering the use of corticosteroids or other immunosuppressive therapies generally unbeneficial.
In such scenarios, therapeutic efforts should focus on supportive care and management of underlying conditions rather than aggressive immunosuppression.