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[Acute interstitial nephritis: clinical presentation and diagnosis]
Daniela Dos Reis1, Solange Moll2, Sophie De Seigneux3
1Service de médecine interne, Département des spécialités de médecine, Hôpitaux universitaires de Genève, 1211 Genève 14.
Revue Medicale Suisse
|March 2, 2022
Summary
Acute interstitial nephritis, often drug-induced, presents with non-specific symptoms and acute kidney injury. Early diagnosis and prompt withdrawal of the offending agent are crucial for preventing kidney damage and improving outcomes.
Area of Science:
- Nephrology
- Internal Medicine
- Pathology
Background:
- Acute interstitial nephritis (AIN) involves renal inflammation and edema.
- Clinical presentation is often subtle, with non-specific symptoms.
- AIN commonly manifests as acute renal failure, potentially with fever, eosinophilia, and urinalysis abnormalities.
Purpose of the Study:
- To summarize the key aspects of acute interstitial nephritis.
- To highlight the importance of early diagnosis and management.
- To discuss diagnostic approaches and treatment considerations.
Main Methods:
- Review of clinical presentation, etiology, diagnosis, and management of AIN.
- Emphasis on drug-induced causes as the most frequent etiology.
- Discussion on the role of kidney biopsy and glucocorticoid treatment.
Main Results:
- AIN is characterized by renal inflammation and edema, often presenting with acute kidney injury.
- Drug-induced causes are the most common etiology.
- Kidney biopsy is not always necessary; diagnosis often relies on clinical context and response to agent withdrawal.
Conclusions:
- Early diagnosis of AIN is critical to prevent morbidity and mortality.
- Withdrawal of the causative agent is the primary management step.
- Glucocorticoid treatment may aid kidney function recovery, though evidence is pending.
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