- Radiologic evolution of biopsy-proven acute interstitial nephritis: a multimodal imaging case report
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Euljo Jeong, Bong Soo Park, Il Hwan Kim, Jung Hee Son, Kyung Han Nam, Yoon Ho Lee, Yoo Jin Lee
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Kosin Med J. 2025;40(1):72-79. Published online March 27, 2025
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DOI: https://doi.org/10.7180/kmj.25.104
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 Abstract
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- This report presents radiologic changes after clinical improvement in a patient with acute interstitial nephritis (AIN). A 45-year-old female patient was referred for decreased renal function. Eight months prior, she had undergone hysterectomy and received chemotherapy. At the start of chemotherapy, her baseline creatinine level was 0.55 mg/dL, which rose to 1.46 mg/dL. Multiple imaging modalities performed when decreased renal function was observed revealed bilateral renal enlargement with increased cortical attenuation on computed tomography (CT), cortical hyperechogenicity on ultrasonography, and diffusion restriction in the renal cortices on magnetic resonance imaging. A renal biopsy was performed, and AIN was diagnosed. Follow-up laboratory tests showed that kidney function had improved to normal levels, and CT at that time showed a reduction in the size of both kidneys. Radiologic changes can serve as clues for the diagnosis of AIN. This is the first report to confirm radiological changes after the clinical improvement of AIN, thereby providing novel information about the course of AIN.
- Clinical significance of copeptin as an early predictor of renal graft dysfunction in renal transplant recipients
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Yoo Jin Lee, Chang Min Heo, Sihyung Park, Il Hwan Kim, Jin Han Park, Junghae Ko, Bong Soo Park, Yang Wook Kim
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Kosin Med J. 2022;37(3):220-227. Published online September 2, 2022
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DOI: https://doi.org/10.7180/kmj.22.107
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Abstract
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- Background
Copeptin is the carboxyl-terminal part of the vasopressin precursor protein, and its concentration is an independent predictor of the onset of chronic kidney disease and a rapid decline in the glomerular filtration rate. The glomerular filtration rate is regarded as the best indicator of kidney transplant function and is a predictor of graft and patient survival. We investigated the clinical significance of copeptin as an early predictor of renal graft dysfunction in renal transplant recipients.
Methods
We measured serum creatinine, cystatin C, and copeptin concentrations in renal transplant recipients on the day of their operation, as well as on postoperative days 3, 7, 30, and 365. Acute rejection was defined as a sudden decrease in renal function accompanied by histological changes.
Results
Eight renal transplant recipients were enrolled in the study from July 2018 to December 2019. Four patients experienced histologically confirmed transplant rejection. All four cases involved acute T-cell rejection. No significant correlation was found between the copeptin level and the presence or absence of rejection at any time point. In subgroup analyses, changes in creatinine, the estimated glomerular filtration rate, cystatin, and copeptin did not show statistical significance.
Conclusions
We anticipated that copeptin would be useful to identify individuals at high risk of transplant rejection; however, our study failed to show an association. Further research will be needed to overcome the limitations of this study.
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KOSIN UNIVERSITY COLLEGE OF MEDICINE
