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Interstitial Nephritis

Touqir Zahra, MD, FACP and Raksha Sharma, MD Reviewed 04/2024
 


BASICS

DESCRIPTION

  • Acute and chronic tubulointerstitial diseases result from the interplay of renal cells and inflammatory cells. Injury to renal cells leads to new local antigen expression, inflammato...

DIAGNOSIS

AIN: suspected in a patient with nonspecific signs and vague systemic symptoms (e.g., malaise/fatigue, fever, nausea, vomiting, rash) with AKI and an abnormal UA 
  • AKI: Elevated creatinine, BU...

TREATMENT

GENERAL MEASURES

  • Discontinue offending agent, including topical NSAIDs

  • Reduce exposure to nephrotoxic agents

  • Supportive measures:

    • Maintain adequate hydration

    • Symptomatic relief for fever and rash

    • ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

If patients must remain on nephrotoxic agents, assess renal function, electrolytes, and phosphorus frequently 

DIET

  • Low potassium (<2 g/day), s...

REFERENCES

1
Muriithi  AK, Leung  N, Valeri  AM, et al. Clinical characteristics, causes and outcomes of acute interstitial nephritis in the elderly. Kidney Int.  2015;87(2...

CODES

ICD10

  • N12 Tubulo-interstitial nephritis, not spcf as acute or chronic

  • N10 Acute tubulo-interstitial nephritis

  • N11.9 Chronic tubulo-interstitial nephritis, unspecified

  • N16 Renal tubulo-interstitial d...

CLINICAL PEARLS

  • First step in treatment is to remove offending agents. Most common in elderly on NSAIDs, proton pump inhibitors and antibiotics.

  • A renal biopsy is preferred and is the gold standard to ...

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