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. 2025 Sep;29(9):1223-1231.
doi: 10.1007/s10157-025-02685-w. Epub 2025 May 8.

Clinicopathological findings of tubulointerstitial nephritis: a cross-sectional analysis of the Japan Renal Biopsy Registry (J-RBR)

Keiko Oda  1 , Joichi Usui  2 , Yukiko Kanetsuna  3 , Tomohiro Murata  4 , Takaya Ozeki  5 , Akira Shimizu  6 , Hitoshi Sugiyama  7 , Shoichi Maruyama  5 ; Committee for Renal Biopsy and Disease Registry of the Japanese Society of Nephrology
Affiliations

Clinicopathological findings of tubulointerstitial nephritis: a cross-sectional analysis of the Japan Renal Biopsy Registry (J-RBR)

Keiko Oda et al. Clin Exp Nephrol. 2025 Sep.

Abstract

Introduction: Tubulointerstitial nephritis (TIN) is an important disease involving a diverse set of factors that can cause both acute kidney injury and chronic kidney disease. The purpose of this cross-sectional study was to clarify the causative diseases and clinicopathological characteristics of TIN using the Japan Renal Biopsy Registry (J-RBR).

Methods: This cross-sectional study analyzed data from 22,049 cases registered in the J-RBR between 2018 and 2022. Clinicopathological findings at diagnosis were investigated.

Results: Of the enrolled cases, 913 were diagnosed with TIN. "Drug-induced" was the most common (232 cases, 25.7%), followed by "IgG4-related kidney disease" (124 cases, 13.7%). Of "Drug-induced" TIN cases, "Chemotherapy-related" was the most common cause (63 cases, 27.2%), including 47 cases of "immune checkpoint inhibitor (ICI)-associated" TIN. IgM-positive plasma cell-rich TIN (IgMPC-TIN), which has been the focus of much attention in recent years, was also included, with 9 cases.

Conclusion: This is the first report of the clinicopathological findings of TIN patients in a large-scale, nationwide registry of renal biopsies. It was possible to identify recent trends in causative diseases, including an increase in chemotherapy-related TIN and IgMPC-TIN.

Keywords: Clinicopathological features; Etiology; IgM-positive plasma cell-rich TIN (IgMPC-TIN); Immune checkpoint inhibitor (ICI)-associated TIN; Renal biopsy; Tubulointerstitial nephritis (TIN).

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no conflict of interest. Ethical approval: All procedures performed in the J-RBR involving human participants were in accordance with the ethical standards of the institutional and/or national research committee at which the studies were conducted (IRB Approval Number H2023-233 at the Ethics Committee of Mie University) and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Informed consent: Informed consent was obtained from all participants included in this study.

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