Interstitial Kidney Disease Flashcards
Renal Interstitial Disease or Renal Tubulo-Interstitial Disease refers to
A group of kidney diseases with evidence of inflammatory inflammation of the tubules and interstitium.
What are the two categories of Primary Interstitial Nephritis?
Acute or Chronic
How do chronic and acute interstitial nephritis differ under the microscope?
Acute - More eosinophils and neutrophils. Tubules are “inflammed.”
Chronic - Prominent interstital fibrosis. Tubules are small/shriveled up (atrophy).
What are the 3 main causes of tubulo-interstitial nephritis?
Drugs
Infections
Autoimmunity
Compare the findings of urine sediment for AIN and CIN
AIN - WBC’s & WBC casts
CIN - Often bland (but can be similar to AIN)
How can Chronic interstital nephritis lead to anemia?
Since the renal interstitium is responsible for EPO release, damage to it over time can decrease the release of EPO.
Acute Interstitial Nephritis is typically due to what type of hypersensitivity reaction?
Type IV - Hypersensitivity reaction
Which drug can lead to both forms (acute & chronic) of interstitial nephritis?
NSAIDs
Which drugs can lead to acute interstitial nephritis?
B-lactam antibiotics (PENICILLIN & cephalosporin)
Sulfonamides
Proton pump inhibitors
Diuretics and others
Systemic autoimmune disorder that primarily targets the exocrine glands especially the lacrimal and salivary glands, but kidney amongst other targets are also attacked.
Sjogren’s Sydnrome
Signs & Symptoms of Sjogren’s Syndrome include
SIcca symptoms (dry eyes & mouth)
Distal RTA symptoms (Hypokalemia)
Nephrogenic Diabetes Insepidus
Lymphocytic renal interstitial infiltrate
What are the 3 diagnostic findings for Sjogren’s Syndrome
Sicca Symptoms
Serology: anti-Ro anti-La
Salivary Gland biopsy
What are the treatment options for Sjogren’s Syndrome?
- Gluccocorticoids
2. Steroid sparing agents (azathioprine, mycophenolate, mofetil)
Multi-system disorder of unknown cause with non-caseating granulomas in affected organs.
Sarcoidosis
Renal manifestations of sarcoidosis include
Granulomatous interstitial nephritis
Non-granulomatous interstitial nephritis
Hypercalcuria and hypercalemia (overactive VitD from overactive macrophages’ 1 aplha hydroxylase)
