Acute interstitial nephritis
| Interstitial nephritis | |
|---|---|
| Classification and external resources | |
| Specialty | nephrology |
| ICD-10 | N10-N12 |
| ICD-9-CM | 580.89, 581.89, 582.89, 583.89 |
| DiseasesDB | 6854 |
| MedlinePlus | 000464 |
| eMedicine | med/1596 |
| MeSH | D009395 |
Interstitial nephritis (or tubulo-interstitial nephritis). is a form of nephritis affecting the interstitium of the kidneys surrounding the tubules, i.e., is inflammation of the spaces between renal tubules. This disease can be either acute, meaning it occurs suddenly, or chronic, meaning it is ongoing and eventually ends in kidney failure.
Common causes include infection, or reaction to medication such as an analgesic or antibiotics such as methicillin (meticillin). Reaction to medications causes 71% to 92% of cases.
This disease is also caused by other diseases and toxins that damage the kidney. Both acute and chronic tubulointerstitial nephritis can be caused by a bacterial infection in the kidneys known as pyelonephritis, but the most common cause is by an adverse reaction to a drug. The drugs that are known to cause this sort of reaction are antibiotics such as penicillin and cephalexin, and nonsteroidal anti-inflammatory drugs (aspirin less frequently than others), as well as proton-pump inhibitors, rifampicin, sulfa drugs, fluoroquinolones, diuretics, allopurinol, and phenytoin. The time between exposure to the drug and the development of acute tubulointerstitial nephritis can be anywhere from 5 days to 5 months (fenoprofen induced).
At times, there are no symptoms of this disease, but when they do occur they are widely varied and can occur rapidly or gradually. When caused by an allergic reaction, the symptoms of acute tubulointerstitial nephritis are fever (27% of patients), rash (15% of patients), and enlarged kidneys. Some people experience dysuria, and lower back pain. In chronic tubulointerstitial nephritis the patient can experience symptoms such as nausea, vomiting, fatigue, and weight loss. Other conditions that may develop include hyperkalemia, metabolic acidosis, and kidney failure.
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