ACUTE INTERSTITIAL NEPHRITIS

SUMMARY

1. Interstitial disease is caused by inflammation and/or fibrosis of the interstitium.

2. Acute interstitial nephritis (AIN) is caused by drug-induced hypersensitivity reaction.

3. Implicated drugs include: NSAIDs, PPI, cimetidine, thiazides, allopurinol and antibiotics (beta-lactams, TMP)

4. NSAID-induced AIN typically causes nephrotic-range proteinuria and glomerular changes consistent with those of minimal change disease.

5. Other causes - sarcoidosis, SLE, Sjogren's, transplant rejection, and infection (e.g., pyelo, Legionella, streptococci).

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].