Immunologically mediated interstitial nephritis: primary and secondary

Tubulointerstitial disease has been reviewed twice in the past five years at the Necker Seminars in Nephrology; why is it necessary to return once again to this topic? Although the importance of the tubulointerstitial component of the kidney is self-evident, the literature on glomerular disease remains vastly greater than that on the tubules and interstitium. In this brief review I wish first to discuss the tubulointerstitial component of what are usually considered glomerular diseases--the glomerulonephritides and lupus, and then to discuss what appear to be primary tubulointerstitial nephritides (TIN), in which the glomeruli are usually spared and the primary attack appears to be on the tubules and interstitium.