Tubulointerstitial Nephritis
What is it?
Tubulointerstitial nephritis is kidney disease
that is caused by damage to the tubules of the
kidneys and the tissues around them, called
interstitial tissue. In simple terms, the kidney
tubules help return filtered substances such as
sodium and water to the blood. Drugs such as
penicillin also move through the tubules and leave
the body through the urine. Also called
interstitial nephritis, this condition can be
acute, meaning it occurs suddenly, or chronic,
meaning it is a recurring problem.
Who gets it?
People who have underlying diseases that damage
the kidneys or bacterial infections of the kidneys
are more likely to develop tubulointerstitial
nephritis. It also occurs in people who have drug
allergies or a build up of toxins from taking a
certain drug for a long time.
What causes it?
The most common cause of acute
tubulointerstitial nephritis is an allergic
reaction to drugs such as penicillins and
sulfonamides. It can also be caused by a toxic
reaction to a drug, which means the drug is
actually poisonous to the patient, or kidney
infection. Chronic tubulointerstitial nephritis is
often caused by taking a drug or toxic substance
for a long time. It can also be caused by disease,
a blockage in the ureter, or transplant rejection.
What are the symptoms?
When acute tubulointerstitial nephritis is
caused by an allergic reaction, symptoms can
include fever, rash, and enlarged kidneys. The
patient can experience sudden kidney failure
(acute renal failure). In others, symptoms may be
similar to a urinary tract infection, with fever,
painful urination, and lower back pain. Symptoms
of chronic tubulointerstitial nephritis include
nausea, vomiting, fatigue, and weight loss. The
patient may also develop hyperkalemia, which is
high potassium levels in the blood, and a
condition called acidosis, in which there is too
much acid in the blood.
How is it diagnosed?
If you have symptoms of tubulointerstitial
nephritis, your doctor will study your medical
history and perform a thorough physical
examination. He or she will look for traces of
protein, blood, or pus in your urine. Pus that
contains a certain type of white blood cell is a
sign that an allergic reaction has triggered acute
tubulointerstitial nephritis. To confirm a
diagnosis, your doctor will remove a small sample
of kidney tissue, called a biopsy, to study under
a microscope.
What is the treatment?
If you have lost a lot of fluid or have an
electrolyte imbalance, you will receive
replacement intravenous (IV) fluids. Acute
tubulointerstitial nephritis is usually cured by
stopping the drug that has caused the symptoms. In
most cases, kidney function returns to normal with
no lasting damage, although there may be some
scarring. Chronic tubulointerstitial nephritis
involves treating the underlying cause, such as
surgical removal of urinary tract obstructions.
Some cases may require dialysis, a process in
which the waste products are filtered from the
blood for the kidneys, or kidney transplant.
Self-care tips
Prompt treatment of acute tubulointerstitial
nephritis is important to prevent lasting kidney
damage. So, see your doctor immediately if you
have any symptoms of this disease. If you have
been diagnosed with acute or chronic
tubulointerstitial nephritis, follow your doctors
recommendations for treatment.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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