{"id":3483,"date":"2019-11-28T13:27:05","date_gmt":"2019-11-28T13:27:05","guid":{"rendered":"http:\/\/edren.org\/ren\/education\/textbook\/interstitial-nephritis\/"},"modified":"2020-08-12T11:36:07","modified_gmt":"2020-08-12T11:36:07","slug":"interstitial-nephritis","status":"publish","type":"page","link":"https:\/\/edren.org\/ren\/education\/textbook\/conditions-that-affect-the-kidney\/interstitial-nephritis\/","title":{"rendered":"Interstitial Nephritis"},"content":{"rendered":"<p>Inflammation within the kidney predominantly affecting tubules.\u00a0 Often seen in conjunction with glomerulonephritis, but then usually regarded as secondary to the glomerular disease. Acute interstitial nephritis is uncommon but important, as prompt therapy can save renal function.<\/p>\n<hr \/>\n<h3><strong><span style=\"color: #993300;\">Recognition<\/span><\/strong><\/h3>\n<p>Often difficult as there may be minimal or no symptoms, and minor urine dipstick abnormalities.\u00a0 Urine often contains white blood cells.\u00a0 Blood tests show renal impairment.<\/p>\n<p><strong><span style=\"color: #993300;\">Causes<\/span><\/strong><\/p>\n<ul style=\"list-style-type: disc;\">\n<li><strong><span style=\"color: #993300;\">Allergic<\/span><\/strong> &#8211; the commonest cause is an allergic reaction to a drug, particularly non-steroidal anti-inflammatory drugs (NSAID) or antibiotics, or proton pump inhibitors (PPIs). Variable time after commencement.\u00a0 Usually responds to withdrawal of the drug and treatment with corticosteroids, which may need to be continued for some weeks.<\/li>\n<li><strong><span style=\"color: #993300;\">Immune<\/span><\/strong> &#8211; as a part of a multisystem autoimmune disease or alone.\u00a0 It is a major feature of renal transplant rejection.<\/li>\n<li><strong><span style=\"color: #993300;\">Toxic<\/span><\/strong> &#8211; a number of toxins can do this.\u00a0 The commonest is immunoglobulin light chains, produced in excess in <a href=\"http:\/\/www.edrep.org\/pages\/textbook\/haematology.php\">myeloma<\/a>.\u00a0 These are filtered freely at the glomerulus but may prove toxic to tubular cells which reabsorb them.\u00a0 Others include heavy metals and plant and fungal toxins.<\/li>\n<li><strong><span style=\"color: #993300;\">Infective<\/span><\/strong> &#8211; acute interstitial nephritis may be seen in a number of viral and other infections.\u00a0 The presence of large numbers of neutrophils in and around tubules suggests active bacterial infection &#8211; pyelonephritis.<\/li>\n<\/ul>\n<hr \/>\n<h3><strong><span style=\"color: #993300;\">Further info<\/span><\/strong><\/h3>\n<ul>\n<li><a href=\"http:\/\/www.edren.org\/pages\/edreninfo\/interstitial-nephritis.php\">Patient info on interstitial nephritis<\/a> (Edren)<\/li>\n<li><a href=\"http:\/\/www.edrep.org\/pages\/resources\/interstitial.php\">More advanced info on Interstitial nephritis<\/a> &#8211; Undergraduate\/Postgraduate level &#8211; online lecture (13 mins)<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Inflammation within the kidney predominantly affecting tubules.\u00a0 Often seen in conjunction with glomerulonephritis, but then usually regarded as secondary to the glomerular disease. Acute interstitial nephritis is uncommon but important, as prompt therapy can save renal function. Recognition Often difficult as there may be minimal or no symptoms, and minor\u2026<\/p>\n<p> <a class=\"continue-reading-link\" href=\"https:\/\/edren.org\/ren\/education\/textbook\/conditions-that-affect-the-kidney\/interstitial-nephritis\/\"><span>Continue reading<\/span><i class=\"crycon-right-dir\"><\/i><\/a> <\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3723,"menu_order":96,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"class_list":["post-3483","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/pages\/3483","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/comments?post=3483"}],"version-history":[{"count":3,"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/pages\/3483\/revisions"}],"predecessor-version":[{"id":3597,"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/pages\/3483\/revisions\/3597"}],"up":[{"embeddable":true,"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/pages\/3723"}],"wp:attachment":[{"href":"https:\/\/edren.org\/ren\/wp-json\/wp\/v2\/media?parent=3483"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}