[Chronic terminal renal failure: an unusual outcome of acute tubulointerstitial nephritis]

Recovery of renal function after acute tubular necrosis usually begins within a few days or weeks, provided the patient does not succumb to the complications of uremia or of the precipitating illness. However, some studies suggest a high incidence of permanent renal failure perhaps reflecting the survival of patients who previously died because of less ideal treatment. Recently, we observed a patient with acute tubulo-interstitial nephritis whose course was notably different from the usual pattern since the patient required chronic dialysis. We believe that the cause of this permanent lesion is multifactorial including age, nephrotoxic agents (aminoglycosides, intravenous contrast media) and perhaps immunological mechanism. Treatment with prednisone did not produce improvement in our case and the patient has been treated by maintenance hemodialysis.