Steroid Treatment in Acute Interstitial Nephritis Quinto 2015-Dec.-13 1 Title: A systematic review examining the effectiveness of steroids versus supportive therapy for the treatment of drug-induced acute interstitial nephritis

Acute interstitial nephritis (AIN) is an inflammatory condition of the kidneys. There are many different causes of AIN however, one major cause is an immune mediated hypersensitivity reaction to medications. Individuals who are at most risk of developing AIN are those who are hospitalized and being treated with multiple medications. The signs and symptoms associated with AIN are very nonspecific and the presentation may differ depending on the offending drug, the individual and accompanying comorbidities thus diagnosis can be difficult. If AIN is not quickly identified, and the offending drug is not discontinued, kidney damage can progress to the development of acute kidney injury (AKI) or chronic kidney disease (CKD). Since AIN is an inflammatory condition, it has been proposed that steroids may help reduce inflammation, improve kidney function and reduce the risk of subsequent CKD. However, no randomized control trials or systematic reviews examining this question have been performed. The purpose of this review is to critically assess the studies that have compared supportive therapy versus steroid treatment for drug-induced allergic AIN.