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Interstitial nephritis

Definition:

Interstitial nephritis is a kidney disorder in which the spaces between the kidney tubules become swollen (inflamed). This can cause problems with the way your kidneys work.



Alternative Names:

Tubulointerstitial nephritis; Nephritis - interstitial; Acute interstitial (allergic) nephritis



Causes:

Interstitial nephritis may be temporary (acute ), or it may be long-lasting (chronic ) and get worse over time.

The acute form of interstitial nephritis is most often caused by side effects of certain drugs.

The following can cause interstitial nephritis:

  • Allergic reaction to a drug (acute interstitial allergic nephritis).
  • Autoimmune disorders, such as antitubular basement membrane disease, Kawasaki disease, Sj√∂gren¬†syndrome, systemic lupus erythematosus, or Wegener granulomatosis.
  • Infections.
  • Long-term use of medicines such as acetaminophen (Tylenol), aspirin, and nonsteroidal anti-inflammatory drugs (NSAIDs). This is called analgesic nephropathy .
  • Side effect of certain antibiotics (including penicillin, ampicillin, methicillin, sulfonamide medicines, and others).
  • Side effect of other medicines such as furosemide, thiazide diuretics, omeprazole, triamterene, and allopurinol.
  • Too little potassium in your blood.
  • Too much calcium or uric acid in your blood.


Symptoms:

Interstitial nephritis can cause mild to severe kidney problems, including acute kidney failure . In about half of cases, people will have decreased urine output and other signs of acute kidney failure.

Symptoms of this condition may include:



Exams and Tests:

The health care provider will perform a physical exam. This may reveal:

  • Abnormal lung or heart sounds
  • High blood pressure
  • Fluid in the lungs (pulmonary edema)

Common tests include:



Treatment:

Treatment depends on the cause of the problem. Avoiding medicines that lead to this condition may quickly relieve symptoms.

Limiting salt and fluid in the diet can improve swelling and high blood pressure. Limiting protein in the diet can help control the buildup of waste products in the blood (azotemia ) that can lead to symptoms of acute kidney failure.

If dialysis is necessary, it usually is required for only a short time.

Corticosteroids or stronger anti-inflammatory medicines such as cyclophosphamide can sometimes be helpful.



Outlook (Prognosis):

Most often, interstitial nephritis is a short-term disorder. In rare cases, it can cause permanent damage, including chronic kidney failure.

Acute interstitial nephritis may be more severe and more likely to lead to long-term or permanent kidney damage in older people.



Possible Complications:

Metabolic acidosis can occur because the kidneys aren't able to remove enough acid. The disorder can lead to acute or chronic kidney failure or end-stage kidney disease .



When to Contact a Medical Professional:

Call your provider if you have symptoms of interstitial nephritis.

If you have interstitial nephritis, call your provider if you get new symptoms, especially if you are less alert or have a decrease in urine output.



Prevention:

Often, the disorder can't be prevented. Avoiding or reducing your use of medicines that can cause this condition can help reduce your risk.



References:

Arend LJ. Tubulointerstitial diseases. In: Lager DJ, Abrahams NA, eds. Practical Renal Pathology. Philadelphia, PA: Elsevier Saunders; 2013:chap 7.

Nangaku M. Chronic interstitial nephritis. In: Johnson RJ, Feehally J, Floege J, eds. Comprehensive Clinical Nephrology. 5th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 64.




Review Date: 9/22/2015
Reviewed By: Charles Silberberg, DO, private practice specializing in nephrology, affiliated with New York Medical College, Division of Nephrology, Valhalla, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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Morristown Medical Center

100 Madison Avenue
Morristown, NJ 07960
973-971-5000

Overlook Medical Center

99 Beauvoir Avenue
Summit, NJ 07901
908-522-2000

Newton Medical Center

175 High Street
Newton, NJ 07860
973-383-2121

Chilton Medical Center

97 West Parkway
Pompton Plains, NJ 07444
973-831-5000

Hackettstown Medical Center

651 Willow Grove Street
Hackettstown, NJ 07840
908-852-5100

Goryeb Children's Hospital

100 Madison Avenue
Morristown, NJ 07960
973-971-5000

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