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interstitial nephritis
Etiology:
1) acute interstitial nephritis
2) analgesic nephropathy (NSAIDs)*
3) papillary necrosis
4) toxin- & electrolyte-induced interstitial nephritis
a) uric acid nephropathy*
b) hypercalcemia
c) hypokalemia
d) hyperoxaluria
1] ethylene glycol
2] methoxyflurane
3] high doses of ascorbic acid
4] vitamin B6 deficiency
5] excessive gut absorption in patients with steatorrhea
e) cystinosis
f) heavy metals*#
1] lead
2] cadmium
3] mercury
g) pharmaceutical agents*#
1] cyclosporine
2] some antibiotics
3] mesalamine [5]
4] radiographic contrast media
h) plastics
i) pigments
l) glass
m) electrical equipment manufacturing
n) some cigarettes
o) aristolochic acid nephropathy from ingestion of Chinese herb toxin [5]
5) other disease associations
a) glomerular injury
1] lupus nephritis
2] mixed cryoglobulinemia
3] hypertension
4] diabetes mellitus
5] Sjogren's syndrome
6] Alport's syndrome
7] amyloidosis, including myeloma*
8] Fabry's disease
9] glomerulonephritis (in general)
b) Balkan nephropathy (associated with increased incidence of urogenital tumors
c) granulomatous nephropathy
1] tuberculosis
2] sarcoidosis
d) neoplasia
1] lymphoma
2] leukemia
e) immune disorders
1] hypersensitivity nephropathy*#
2] transplant rejection
3] AIDS
f) vascular disorders
1] arteriolar nephrosclerosis
2] atheroembolic disease
3] sickle cell trait/disease
4] acute tubular necrosis*#
g) hereditary disorders
1] medullary cystic & medullary sponge disease
2] polycystic kidney disease
h) infectious: acute*# & chronic pyelonephritis
i) chronic urinary tract obstruction (obstructive uropathy)
j) vesiculoureteral reflux*
k) radiation nephritis
l) tubulointerstitial nephritis with uveitis
* common, 10 days of NSAID therapy prior to interstitial nephritis [7]
# acute
Related
hyperoxaluria
Specific
acute interstitial nephritis
chronic interstitial nephritis (analgesic nephropathy, drug-induced chronic interstitial nephritis)
lead nephropathy
renal papillary necrosis
tubulointerstitial nephritis with uveitis (TINU)
General
nephritis
tubulointerstitial nephropathy
References
- Harrison's Principles of Internal Medicine, 13th ed.
Companion Handbook, Isselbacher et al (eds), McGraw-Hill
Inc. NY, 1995, pg 829-39
- Manual of Medical Therapeutics, 28th ed, Ewald &
McKenzie (eds), Little, Brown & Co, Boston, 1995, pg 266
- Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed)
Lippincott-Raven, Philadelphia, 1998, pg 612
- Harrison's Principles of Internal Medicine, 13th ed.
Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 1314
- Medical Knowledge Self Assessment Program (MKSAP) 17, 18, 19.
American College of Physicians, Philadelphia 2015, 2018, 2021.
- Zhang P, Cornell LD.
IgG4-Related Tubulointerstitial Nephritis.
Adv Chronic Kidney Dis. 2017 Mar;24(2):94-100. Review.
PMID: 28284385
- NEJM Knowledge+