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Interstitial Nephritis / Tubulointerstitial nephritis Are clinically heterogeneous disorders that share similar features

Interstitial Nephritis / Tubulointerstitial nephritis Are clinically heterogeneous disorders that share similar features of tubular and interstitial injury In severe and prolonged cases, entire kidney may become involved, with glomerular dysfunction and even renal failure

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Interstitial Nephritis / Tubulointerstitial nephritis Are clinically heterogeneous disorders that share similar features

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  1. Interstitial Nephritis / Tubulointerstitial nephritis Are clinically heterogeneous disorders that share similar features of tubular and interstitial injury • In severe and prolonged cases, entire kidney may become involved, with glomerular dysfunction and even renal failure Acute interstitial nephritis • There is inflammation of interstitium and tubules. Dr S Chakradhar

  2. Causes • Allergic reaction to Drugs (penicillin, cephalosporins, NSAIDs, sulphonamides, rifampicin etc), • Infections (pyelonephritis, tuberculosis) Dr S Chakradhar

  3. Clinical features • Patients may give history of drug hypersensitivity, • Fever, Rash, Arthralgia , • Acute Renal Failure (non – oliguric) Investigations • TC, DC, ESR, Hb • Urine RME – RBC, WBC, WBC cast, proteinuria & eosinophiluria • Renal biopsy – Confirmatory Dr S Chakradhar

  4. Management • Withdrawal of precipitating factor - Drug or treatment of infection, • Corticosteroid may hasten recovery and minimize scarring • Supporting treatment for ARF Dr S Chakradhar

  5. Chronic interstitial nephritis • May progress from acute disease • Or progressive without obvious acute injury • Resulting in interstitial fibrosis & tubular atropy Dr S Chakradhar

  6. Causes : Heterogenous group • Any cause of acute interstitial nephritis if persists • Glomerulonephritis, • Autoimmune diseases, • Toxin-Mushrooms, lead, • Drugs-NSAIDs, • Obstructive • Congenital • Metabolic Dr S Chakradhar

  7. Clinical features Most pt present in adult life with • CRF – moderate uraemia, severe hyperklaemia & acidosis • HTN • Small kidney Treatment • Avoidance of offending toxins or drugs, • Supportive measures for CRF Dr S Chakradhar

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