Acute Interstitial Nephritis

Question 1

Define acute interstitial nephritis

Answer 1

Inflammation or fibrosis of renal interstitium
Eventual atrophy of tubular compartment targeting the glomerulous and vasculature

Question 2

Medication causes of AIN

Answer 2

ABX, NSAIDS, Diuretics, Anticonvulsants

Question 3

Infectious causes of AIN

Answer 3

Strep, staph, legionella, salmonella, EBV, CMV, mycoplasma, histoplasma

Question 4

Autoimmune causes of AIN

Answer 4

Sjögren’s syndrome, lupus, idiopathic

Question 5

Acute obstructive causes of AIN

Answer 5

Light chain casts and nephropathy
Acute phosphate or acute urate nephropathy

Question 6

S/s of AIN

Answer 6

ARF
Inflammatory infiltrates: caused by tissue edema, tubular injury, and compromised blood flow
Obstruction: caused by casts, cellular debris
Urinary sediment: caused by leukocytes
Fever, rash, peripheral eosinophilia, oliguric RF
Elevated creatinine

Question 7

What does peripheral blood and UA shoe in AIN

Answer 7

Blood: Eosinophilia
UA: pyuria, WBC casts, hematuria, eosinophilia

Question 8

Treatment plan for AIN

Answer 8

D/c offending agent
Glucocorticoids
Dialysis