577
www.urologiepropraxi.cz3408040010765133201214261288335354403453471515565592639689716757797816832872911
/35638040010732
Urol.3640804001075682129149164
praxi.3824804001075077118158177193
2025;26(3):165-1684037804001074487128172185229272295338359373411450492520559598643
/47258040010731
UROLOGIE48028040010756103166209268327348392
PRO5215804001074592154
PRAXI5391804001074591147200220
16556558020012657111168
VE5028200012667125
ZKRATCE5175200012658126191263317378436
Chronické434536001063274109150191209243279311
tubulointersticiální467236001063071107148179218236277309342378412444462497514554585627644
nefritidy533236001063971102137155187205244280
Chronické34092002981432803695076467098169451067
tubulointersticiální145592002988822736950857270977391299711221212131614031468157416391764182819672031
nefritidy35349200298141266347437500586652793918
MUDr.3401320013793168245287310
Petra6721320013764121162204262
Bachroňová,9561320013766125174239280344409472529587616
MUDr.15941320013793168245288310
Michal19271320013793123173238296326
Sýkora,22751320013759114174236278335365
prof.26621320013766108171209235
MUDr.29191320013793168245288311
Ivan3252132001373189147211
Rychlík,34861320013765124172237267297358390
CSc.,38981320013766125175205234
FASN,41541320013758126186262291
FERA,44681320013758115181256287
FISN4777132001375888148224
Interní340148001332687122176211272297
klinika661148001335178103163188239293
3.977148001335678
LF10781480013352105
UK12061480013371131
a13601480013353
FNKV,14361480013354124183248264
Praha1724148001335892145206258
Tubulointersticiální340199001214997153207230284307362393442474513546569613635682705759782
nefritidy11391990012154104133166189221244299346
(TIN)1502199001212880104168195
představují1714199001215789137194232265313359414437459
rozsáhlou2190199001213386127168216270293347402
skupinu2609199001213985139195218272326
poměrně29521990012156111194243275330380
heterogenních33491990012155104137185218271327376431340213001215577120173
onemocnění,5302130012154108157239292337390439493515535
jejichž108121300121247396118162215257
společným1354213001213994149172221265318363445
rysem1815213001213281120169250
je2082213001212472
dominantní21712130012155109191213267313367398452474
postižení26622130012155110148181203244292347369
tubulů3047213001213386141195218271
a33342130012148
intersticia.3398213001212377108156188227259281325347393414
Patofyziologickým3402270012153100133187216267312335390414469526549594640690774
procesem1132227001215790145190239279329413
je1563227001212474
imunitně16552270012124107161217240273328378
mediovaná20512270012184134191215270317365420468
infiltrace2537227001212479108134157190223271316365
zánětlivými2920227001214392148198231254277326376460484
buňkami.34222270012156112167214263346369390
Při340241001215384108
poškození4652410012157113152198251293342398421
buněk9032410012157112167217264
ledvin1185241001212373130178202257
dochází14602410012156111156211258301325
k18022410012147
expresi1867241001215097153186236275298
lokálních2182241001212479126175198252275320374
antigenů,25742410012148103135158214264319373394
infiltraci2986241001212378106132155188220269313336
zánětlivých3340241001214292147197230253276324374418472
buněk3402550012157112168218265
a6242550012148
aktivaci692255001214894130153202250295318
cytokinů,1029255001214594131185232257312367387
které1436255001214682132164214
působí16692550012157113151207264288
prozánětlivě1976255001215689144186236291341375398421469518
a25132550012148
rovněž2580255001213388135191241284
jako2884255001212472118172
chemoatraktanty.30752550012145100151234289338371403452498534583638671720737
Produkce340269001215385139197251298342391
cytokinů752269001214594131185232257312367
zánětlivými1140269001214393148198232255278326377461484
buňkami16462690012156112167214263346369
(makrofágy,20372690012128109157203237292321370426474490
lymfocyty)2548269001212471156185240285335371421448
je3017269001212474
zprostředkována31132690012143100133187226260293342400446500547596651699
i3402830012123
buňkami3812830012157112167213262345368
ledvin767283001212373130178202257
(proximální1042283001212884117171216240322370393448471
tubulus,1531283001213387144199222277315336
vaskulární1885283001214896135181236259307339395418
endoteliální23202830012150106162217249298322345392416470493
buňky,28312830012157112167213263279
buňky31282830012156112167213263
intersticia3409283001212378110159192232265288332355403
a3402970012148
fibroblasty)410297001213056112145200257281329368402452478
a9112970012148
vede981297001214897154205
k12082970012147
jizvení127729700121244890141190246269
intersticia,1568297001212479111160193234267290335358406427
fibróze2017297001212956112145200241291
a23312970012148
tubulární2401297001213388145200224272304360383
atrofii,2806297001214881113168197223246267
výsledkem3095297001214899138161212269316365448
čehož3565297001214594150205247
je340312001212475
progresivní436312001215790144201233283323346394450473
chronické9303120012145100133187243266311357406
onemocnění13573120012155111161245300346401451507530
ledvin.1908312001212474131180204259280
Chronické3403260012158113146201257281326373423
TIN782326001215075141
je943326001212475
možné10373260012183139182238289
dle1345326001215680131
etiologie1496326001214983107163187243300324375
rozdělit1890326001213388130187238262286320
na22293260012155104
infekční,2352326001212479109160208252307331352
typicky2724326001213383141165211258309
chronická30523260012145100133188244268313360410
bakteriální34823260012156106153189239273297340340001214872128152
pyelonefritida,5123400012157104154179235291342373407432465489547595617
a11493400012148
na12173400012155104
neinfekční,13413400012155106131187216267315360416440461
kde18223400012146102154
dochází19953400012157112159215263307332
k23463400012147
zánětlivému2413340001214393149200235259282332381466521
procesu2954340001215791146192242282338
vlivem331134000121487397146196280
léků,3611340001212475123179200
metabolických3403540012183135169219277334359383429476527572628
poruch,9973540012156113147204250306327
cystických1353354001214595136171195240288339384440
hereditárních18213540012156107141192250274308358392448472518574
onemocnění,24233540012155112164248304351407458515539561
jiných3012354001212448105151196252
genetických32923540012156108164216250274320367419464520
tubulopatií,340368001213388145201225281338388421445468489
autoimunitních8493680012148103136191215298354409433467522546591647
onemocnění15153680012155111162246301347403454510534
nebo20683680012155106164220
v23073680012148
dětství23753680012156106140181216267291
vezikouretrálním2686368001214897141165212266322355405440473522546601625708
refluxem.3414368001213283113140195243292376398
Rovněž3403820012153108156212263306
může6653820012183138181231
dojít9153820012156111135159192
k11273820012146
sekundárnímu1192382001213990138193249305354386442466549604
postižení18153820012156113152186210253303359382
tubulointersticia,2216382001213388145201224280304359392441474515549573618641689711
např.29463820012155103160193209
při3174382001215690113
vaskulárním3307382001214796135182238261310342398422505
či340396001214569
ischemickém432396001212363109165217301325371419468553
postižení10083960012157114154189213257308364389
ledvin.1420396001212375133182207263286
Klinický340410001215581106163187233281333
obraz7044100012156115149199244
chronických9794100012145102136192250274321369421466523
TIN1533410001215076144
je1708410001212476
často1815410001214596136172227
nespecifický,20734100012156108150208261308332363391437485537555
spíše2659410001214098123166218
oligosymptomatický,2908410001215581105163220261310397455490546631681715740786834886904
projevy340424001215893149175227277330
jsou701424001212566123180
mírnější9134240012184109144202254280321345
než12894240012157109155
u14754240012156
akutních1562424001214998155190248273319377
forem1970424001212987121173260
a22614240012149
mohou23414240012185142200257315
se2687424001214093
manifestovat28114240012185135193217248301342378434483534568
jak3411424001212474123
různé3565424001213391136194246
tubulární340438001213388145201225273306362385
dysfunkce,7454380012156104143174230286333377426446
tak1211438001213282129
i13594380012123
jako1401438001212473120174
progresivní1594438001215690145202235285325348397453477
renální2090438001213282138187211266289
insuficience.2399438001212378118172202229274297348404449498519
Léčba2937438001214797143200249
je3205438001212475
cílená329943800121446894144200249
podle35674380012156112170194245
primární340453001215791115200249282339363
příčiny.726453001215791115161185241287305
Klíčová340469001246190118163220272325
slova:686469001244371129181234260
tubulointersticium,967470001213388145200224279302357390439472512546569614637691774795
nefritidy,17834700012156106136170193226249306353369
chronické2174470001214499132186242265310356405
tubulointersticiální2600470001213388145201224279303358390439472513546569614637685708763786
nefritidy.34084700012155106135169192225248305352369
Chronic3404990012460118156214273301346
tubulointerstitial707499001243695156214242301328387424477516560597625662691744772
nephritis14994990012459112172231270297334362406
Tubulointerstitial340516001215097153208230284307361392440472512544566599621667690
nephritis10495160012155105161215247269302324361
(TIN)1429516001212980103168195
represents1642516001213382138170219257307361393432
a20935160012148
broad2160516001215789142190246
group2425516001215587141195251
of2694516001215583
relatively2796516001213382105152183205252301324370
heterogeneous31855160012155105137185217271327376431480535589627
diseases,340530001215679116166213251300339359
characterized724530001214599146177225269303351383406448496553
by13025300012157102
predominant1430530001215688137193248330352407454508539
involvement1994530001212478123176199247295377427482513
of2532530001215583
the2640530001213388137
tubules2802530001213387143197220269308
and31355300012148102158
interstitium.3318530001212378109157189228261283315337391473494
The3405440012149103152
pathophysiological5075440012156103133186240295348392430451504526579634655698745766
process1288544001215688140184231268306
involves1609544001212376120172194241288325
immune-mediated19495440012123104185238291339371453501557578624655702757
infiltration2721544001212376103128149181211258289310363417
by31535440012156100
inflammatory3268544001212376104128174255336382412464496544
cells.340559001214491114135172192
When5475590012183137185239
kidney801559001214669124177226270
cells1086559001214592114135172
are1273559001214878126
damaged,14145590012156102183229283331386405
local1834559001212477120167189
antigens20385590012147100131152206255308345
are2398559001214878126
expressed,2539559001214995150181229267304352407426
leading2980559001212472118173194247301
to3296559001213385
infiltration3396559001212376103128149180211258288310363416
by3405730012157102
inflammatory458573001212377104130176258340386418470502551
cells1025573001214492115137174
and12155730012148102157
activation1388573001214891125147194241273295348402
of1806573001215583
cytokines,1904573001214593128181227251305354392412
which23315730012174128150193247
act2594573001214891125
both27355730012157111143197
proinflammatory2948573001215688141163217245270317398480527558611642692
and36555730012148102157
as340587001214885
chemoattractant.440587001214598146228281328359393424470513547594647678698
Cytokine1153587001215797132184229253306355
production1523587001215688140196248292325347400454
by19925870012156101
inflammatory2108587001212377104129175256337383414466498546
cells2669587001214592114136173
(macrophages,28575870012128107153196227280335389435489538576595
lymphocytes)3467587001212469151206260314340601001214593129177215239
is595601001212361
also672601001214871108162
mediated8506010012184133189212258290338394
by12606010012157102
kidney1378601001214771126181230276
cells1670601001214492115137175
(proximal1861601001212884116169214236318365388
tubular2265601001213387142197219266297
cells,2578601001214593116138176196
vascular2790601001214895133177231253300331
endothelial31376010012151105161215246300350373395441464
cells,3617601001214592115138175195
interstitial340615001212378109158190229262285317339386408
cells,775615001214593116138176197
and9986150012148103159
fibroblasts),1183615001212954110143196253276323361394434458476
resulting1685615001213382121174197229251305361
in2072615001212478
interstitial2176615001212478110158190230263285317339386409
scarring,2611615001214084132164196219273328348
fibrosis,2986615001212954110142196234256294315
and33276150012148103159
tubular3512615001213387143198220268299
atrophy,340629001214880111165221276320335
ultimately695629001215577109131213260292340363410
leading1124629001212373120175197252307
to1450629001213386
progressive1555629001215789143198230279317355377425473
chronic2047629001214599130184238260304
kidney2370629001214771127181230276
disease.2665629001215779116166213251301320
Chronic3406430012158113146201257280325
TIN694643001215075141
can863643001214594150
be10416430012158109
etiologically1179643001215084107162187242299323368417440464511
divided1719643001215680128153209260318
into2065643001212479112166
infectious,2260643001212379108159205240263319374414435
typically2724643001213383141165210259282306354
chronic31066430012145100133188244267312
bacterial34476430012157106151187236270293341365
pyelonephritis,3406570012157103153177232287338395451483507540563602623
and9876570012148103160
non-infectious,11716570012155110166198223278307357403438461516571610631
where18266570012174130180213263
the2113657001213388138
inflammatory2275657001212479108134182265348397429483516566
process2865657001215790145190239279318
is3207657001212362
triggered329365700121336689145201252284334392
by37086570012157104
medications,3406710012184134192215260309342365420476515536
metabolic9056710012183134168217274330354377422
disorders,1356671001215680119174207264314347388409
cystic1793671001214595135169192237
diseases,2058671001215780119170218257308348369
autoimmune24556710012149103137191215298382437492543
diseases3026671001215780119170218257308348
or3402671001215588
vesicoureteral3519671001214897137160205259340685001215588137171220253302325
reflux693685001213383112139193240
in962685001212378
childhood.10686850012145100123147203258314369426447
Secondary1544685001214999145199254311359391442
involvement2014685001212379125179203251300384434490522
of2565685001215584
the2677685001213388139
tubulointerstitium2844685001213388144200223278302357389439472512546569602625679763
may36356850012183131177
also340700001214871109164
occur,522700001215499142197229245
for784700001212984116
example,918700001215096144227283307357376
in1312700001212378
vascular1407700001214896135179234257304336
or1761700001215487
ischemic1865700001212462107161211294317361
kidney2244700001214771127182232278
injury.2540700001212378101155187237253
The28107000012150106156
clinical298370000121456890145168212260283
presentation3284700001215689138177227282314363395418472527
of340714001215584
chronic4497140012145100133187243266310
TIN785714001214974140
is950714001212462
often1038714001215584120169225
nonspecific12887140012156111167205262313359382411437482
and17957140012148103160
rather1980714001213382114169220253
oligosymptomatic,2258714001215579102158213252300385441474528612660693716760782
with3065714001217397130185
milder32767140012183106130186236269
manifestations35717140012183131186209340728001212979119153202234257312368407
than773728001213388136192
in991728001212479
acute1097728001214893147181230
forms.1353728001213085118201240262
It1641728001212457
may17257280012183131177
present1929728001215789139179229285317
as2273728001214887
various2387728001214896129152207263302
tubular2715728001213388145201224272304
dysfunctions30467280012156104143174229285330365388443499537
or3610728001215588
as3725728001214887
progressive340742001215789144200232282321360383431480
renal837742001213383138186209
insufficiency.1064742001212378116171200232258303325375431475525541
Treatment1623742001214976125173205288339394426
is2067742001212362
targeted2146742001213382114170220253302359
according2523742001214892136189222278300355411
to2952742001213387
the3056742001213388138
primary3212742001215790113196244276326
cause.3556742001214493147186236256
Key3407580012461113164
words:5257580012476133171231275301
tubulointerstitium,847759001213388145200224279302357390439472512546569602625680763784
nephritis,16527590012155106163219251275308331370391
chronic20647590012145100132187243266310
tubulointerstitial2395759001213488145201224279303358390439472513546570603626673697
nephritis.31137590012156106163219251275308331370391
DECLARATIONS:4069201008648871301662142563043393604124625014570201008514
Declaration406821500874987120141179206244271291333375
of445721500874066
originality:45372150087406888130150192230251271298337356
The406822600853473109
manuscript418822600855891130168195227249266306329
is452822600851744
original45832260085386178117133172205222
and481622600853472112
has49392260085387299
not50502260085387699
been516122600853975110149
published532222600853977117134150177216251291
or406823700853862
submitted414523700852867108167184208234269310
elsewhere.44702370085355381117169209245269305320
Ethics406825100873764107127160192
approval427425100873780123150192229267288
and457625100873779122
consent471225100873173115146184227253
to497925100872667
participate:506125100874180107135156188209252290317355374
The406826200853575111
authors41992620085347397137176200229
attest44482620085345883119147172
that46402620085236297120
their47802620085236399117140
study49402620085285292132166
is512626200851745
in519026200851756
compliance526626200853270130170188205239279311347
with40682730085526993133
human421627300853978138172212
studies44442730085275291132149185214
committees467327300853270130189206230256291328356
and504527300853473114
animal51752730085347390149184201
welfare539227300855287105126161185221
regulations406828400852461103144163199224242283325354
of444528400854062
the453028400852465103
authors’465628400853576101142183209239256
institutions49342840085175988114132157199224242283325354
as531128400853565
well539828400855491110128
as554928400853464
with40682950085526993133
the42212950085236299
Food433929500853573113154
and451329500853473114
Drug464729500854771111151
Administration481829500854283142159199216244268292327351368407447
guidelines,52852950085397996136173190207247283312328
including40683060085175791109149190208249290
patient437930600854177101119156197221
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