Acute interstitial nephritis
Acute interstitial nephritis is a kidney disorder characterized by the inability of the kidneys to effectively filter waste materials and fluids, which can lead to serious health complications. This condition may arise from various causes, including infections like Streptococcus, herpes, and hepatitis C, as well as certain medications such as antibiotics and nonsteroidal anti-inflammatory drugs (NSAIDs). Those at higher risk include adults using specific drugs and children who have infections.
Symptoms typically include decreased urine output, blood in the urine, nausea, vomiting, and general weakness, among others. Diagnosis often involves blood tests, urine tests, kidney ultrasounds, and, in some cases, a kidney biopsy. Treatment strategies may involve discontinuing causative medications, administering antibiotics for infections, and using corticosteroids or other immunosuppressive drugs to manage inflammation. In severe instances, patients might require dialysis to assist with kidney function.
Preventive measures may include avoiding certain medications to lower the risk of developing acute interstitial nephritis. Understanding this condition is crucial for ensuring timely medical intervention and improving patient outcomes.
Acute interstitial nephritis
- ANATOMY OR SYSTEM AFFECTED: Kidneys, urinary system
Definition
Acute interstitial nephritis is a kidney disorder in which the kidneys cannot properly filter waste materials and fluid. This is a potentially serious condition that requires medical attention.
Causes
Acute interstitial nephritis can be caused by infections such as Streptococcus infection, herpes, mumps, hepatitis C, syphilis, and human immunodeficiency virus (HIV). It can also be caused by particular medications, including certain antibiotics, antiulcer drugs, nonsteroidal anti-inflammatory drugs, certain diuretics, and conditions that affect the immune system (such as lupus).
Risk Factors
The risk factors that increase the chance of developing acute interstitial nephritis include drug and medication use in adults and infection in children.
Symptoms
Symptoms of acute interstitial nephritis include a decrease in urine output, blood in urine, nausea, vomiting, loss of appetite, weakness, aching joints, fever, and rash.
Screening and Diagnosis
Screening for acute interstitial nephritis may include blood tests for levels of BUN (blood urea nitrogen), creatinine, electrolytes, phosphorus, uric acid, and calcium; urine tests; a kidney ultrasound; and, in severe cases, a kidney biopsy.
Treatment and Therapy
If medications are the cause of the interstitial nephritis, a doctor may cease the patient’s medications or prescribe different ones. Antibiotics are used to treat an infection, and drugs such as corticosteroid or cyclophosphamide medications may also be used to help treat interstitial nephritis. A kidney biopsy is often done to confirm the diagnosis before starting corticosteroid or cyclophosphamide. Some people with interstitial nephritis need dialysis, in which a machine does the work of the kidneys to purge waste.
Prevention and Outcomes
To help reduce the chance of developing acute interstitial nephritis, a doctor may suggest avoiding certain medications, such as penicillin, ampicillin, methicillin, thiazide diuretics, or nonsteroidal anti-inflammatories.
Bibliography
"Interstitial Nephritis." MedlinePlus, 28 Aug. 2023, medlineplus.gov/ency/article/000464.htm. Accessed 3 Feb. 2025.
Plakoglannis, R., and A. Nogid. “Acute Interstitial Nephritis Associated with Coadministration of Vancomycin and Ceftriaxone: Case Series and Review of the Literature.” Pharmacotherapy 27 (2007): 1456-1461.
Schrier, Robert W., ed. Diseases of the Kidney and Urinary Tract. 8th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2007.
Sierra, F., et al. “Systematic Review: Proton Pump Inhibitor-Associated Acute Interstitial Nephritis.” Alimentary Pharmacology and Therapeutics 26 (2007): 545-553.