Acute Interstitial Nephritis

Definition

Acute interstitial nephritis is a kidney disorder that happens when the kidneys are unable to filter waste and fluid properly due to inflammation of the kidney.
Anatomy of the Kidney
Glomerulonephritis
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Causes

Acute interstitial nephritis can be caused by:
  • Certain medications
    • Antibiotics
    • Anti-ulcer drugs
    • Nonsteroidal anti-inflammatory drugs
    • Diuretics
  • Infections such as:
  • Conditions that affect the immune system such as lupus

Risk Factors

Risk factors that increase your chance of developing acute interstitial nephritis include:
  • In adults: drug or medication use
  • In children: infection

Symptoms

Symptoms include:
  • Decrease in urine output
  • Blood in urine
  • Side or loin pain
  • Swelling of the body
  • Nausea and vomiting
  • Loss of appetite
  • Weakness
  • Aching joints
  • Fever
  • Rash

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Tests may include:

Treatment

Talk with your doctor about the best treatment plan for you. You treatment will depend on the cause of your acute interstitial nephritis. Treatment options include the following:

Medications

If medications are the cause of your interstitial nephritis, your doctor may have you stop taking medications or prescribe a different one.Your doctor may prescribe the following:
  • Antibiotics to treat infection
  • Corticosteroid or cyclophosphamide to treat interstitial nephritis
Usually, a kidney biopsy is done to confirm the diagnosis before starting a corticosteroid or cyclophosphamide.

Dialysis

Some people with interstitial nephritis need dialysis . During dialysis, a machine does the work of your kidneys by removing waste.

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Prevention

To help reduce your chances of developing acute interstitial nephritis, your doctor may suggest you avoid certain medications such as penicillin or nonsteroidal anti-inflammatory drugs.

RESOURCES

National Kidney Foundation
http://www.kidney.org

National Kidney and Urologic Diseases Information Clearinghouse
http://kidney.niddk.nih.gov

CANADIAN RESOURCES

Health Canada
http://www.hc-sc.gc.ca

Kidney Foundation of Canada
http://www.kidney.ca

References

Acute interstitial nephritis. DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated November 10, 2010. Accessed July 12, 2013.

Kodner CM, Kudrimoti A. Diagnosis and management of acute interstitial nephritis. Am Fam Physician. 2003 June 15;67(12):2527-2534. Available at: http://www.aafp.org/afp/20030615/2527.html. Accessed July 12, 2013.

Plakoglannis R, Nogid A: Acute interstitial nephritis associated with coadministration of vancomycin and ceftriaxone: case series and review of the literature. Pharmacotherapy. 2007:27:1456-1461.

Sierra F, Suzrez M, et al. Systematic review: Proton pump inhibitor-associated acute interstitial nephritis. Aliment Pharmaco Ther. 2007:26:545-553.

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