nephrology tubulointerstitial 1 12

AIN

  • vasculature, glomerulus spared
  • causes
    • allergy/drug induced: 70%
    • infections: acute/chronic pyelo
    • autoimmune: sjogren, lupus, sarcoid
    • idiopathic
  • Sx
    • fever, rash, eosinophilia
    • renal failure
  • labs
    • na wasting, acidification, normal to mildly increased proteinuria
    • WBC, hyperkalemia, hypokalemia
  • Urine: WBC, WBC casts, mild RBC, mild proteinuria, maybe eosinophils

Drugs

  • beta lactam
  • sulfonamides
  • bactrim
  • diuretics: sulfa drugs
  • rifampin
  • quinolones
  • nsaids
  • PPI
  • 5-aminosalicylates

  • hep B: MPGN
  • hep C: rpgn
  • fanconi: glucosuria with normal serum glucose

Infuction induced AIN

  • any infection can cause AIN
  • most commonly chronic UTI/pyelonephritis
  • BK nephropathy: reactivation in transplant patients