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Acute Interstitial Nephritis

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Definition

Acute interstitial nephritis is a kidney disorder that happens when the kidneys are unable to filter waste and fluid properly. This is a potentially serious condition that requires care from your doctor.
The Kidneys
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Causes

Acute interstitial nephritis can be caused by:
  • Infections such as:
  • Particular medications (accounts for 85% of all cases)
    • Certain antibiotics
    • Anti-ulcer drugs
    • Nonsteroidal anti-inflammatory drugs
    • Certain diuretics
  • Conditions that affect the immune system (eg, lupus )

Risk Factors

A risk factor is something that increases your chance for getting a disease or condition. Risk factors that increase your chance of developing acute interstitial nephritis include:
  • In adults: drug or medication use
  • In children: infection

Symptoms

If you experience any of these symptoms, do not assume it is due to acute interstitial nephritis. These symptoms may be caused by other, less serious health conditions. If you experience any of them, see your physician.
  • Decrease in urine output
  • Blood in urine
  • Nausea
  • Vomiting
  • Loss of appetite
  • Weakness
  • Aching joints
  • Fever
  • Rash

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Tests may include:

Treatment

Talk with your doctor about the best treatment plan for you. You treatment will depend on the cause of your acute interstitial nephritis. Treatment options include the following:

Medications

If medications are the cause of your interstitial nephritis, your doctor may have you stop taking medications or prescribe a different one.
Antibiotics used to treat an infection and a corticosteroid or cyclophosphamide medicine may also be used to treat interstitial nephritis. Usually, a kidney biopsy is done to confirm the diagnosis before starting a corticosteroid or cyclophosphamide.

Dialysis

Some people with interstitial nephritis need dialysis . During dialysis, a machine does the work of your kidneys by removing waste.

Prevention

To help reduce your chances of developing acute interstitial nephritis, your doctor may suggest you avoid certain medications such as penicillin or nonsteroidal anti-inflammatory drugs.

RESOURCES

American Academy of Family Physicians http://familydoctor.org

National Kidney Foundation http://www.kidney.org

National Kidney and Urologic Diseases Information Clearinghouse http://kidney.niddk.nih.gov

CANADIAN RESOURCES

Health Canada http://www.hc-sc.gc.ca/index-eng.php

Kidney Foundation of Canada http://www.kidney.ca

References

Acute interstitial nephritis. DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated November 10, 2010. Accessed October 19, 2012.

Kodner CM, Kudrimoti A. Diagnosis and management of acute interstitial nephritis. Am Fam Physician . 2003 June 15;67(12):2527-2534. Available at: http://www.aafp.org/afp/20030615/2527.html . Accessed October 19, 2012.

Plakoglannis R, Nogid A: Acute interstitial nephritis associated with coadministration of vancomycin and ceftriaxone: case series and review of the literature. Pharmacotherapy . 2007:27:1456-61.

Sierra F, Suzrez M, Rey M, Vela MF: Systematic review: Proton pump inhibitor-associated acute interstitial nephritis. Aliment Pharmaco Ther . 2007:26:545-53.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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