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Related Concept Videos

Acute Pyelonephritis I: Introduction01:27

Acute Pyelonephritis I: Introduction

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Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such...
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Acute Kidney Injury II: Pathophysiology01:29

Acute Kidney Injury II: Pathophysiology

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Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
63
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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Nephrotic Syndrome I : Introduction01:24

Nephrotic Syndrome I : Introduction

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Nephrotic Syndrome is a chronic kidney disorder defined by clinical findings such as severe proteinuria, hypoalbuminemia, hyperlipidemia, and edema. These symptoms result from damage to the glomeruli, the kidney’s filtering units, increasing their permeability to proteins.Definition and Meaning:Proteinuria, defined as the loss of more than 3.5 grams of protein per day in adults, is a crucial feature of nephrotic syndrome. This condition is often accompanied by edema, the accumulation of...
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Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

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Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
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Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Updated: Sep 2, 2025

Induction of Nephrotic Syndrome in Mice by Retrobulbar Injection of Doxorubicin and Prevention of Volume Retention by Sustained Release Aprotinin
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Acute Interstitial Nephritis Induced by Clozapine.

Praveena Vantipalli1, Sasmit Roy2, Narayana M Koduri3

  • 1Department of Family Medicine, University of Nebraska Medical Center, Omaha, NE, USA.

Journal of Medical Cases
|August 11, 2022
PubMed
Summary

Clozapine can cause acute interstitial nephritis (AIN), a kidney injury, even at low doses. Early detection and drug withdrawal are crucial for preventing severe kidney damage.

Keywords:
Acute interstitial nephritisAcute kidney injuryClozapineDrug reactionsKidney biopsyRefractory schizophreniaSchizophrenia

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Area of Science:

  • Nephrology
  • Psychiatry
  • Pharmacology

Background:

  • Acute interstitial nephritis (AIN) is a kidney disease often caused by medications.
  • Drug-induced AIN is not dose-dependent and can recur upon re-exposure.

Observation:

  • A 50-year-old male with treatment-resistant schizoaffective disorder developed clozapine-induced AIN.
  • Kidney function improved after clozapine withdrawal and steroid treatment.
  • Re-exposure to a lower dose of clozapine a year later caused significant kidney impairment.

Findings:

  • Clozapine can induce AIN, confirmed by kidney biopsy.
  • AIN recurrence occurred upon rechallenge with clozapine, even at a lower dose.
  • Discontinuation of clozapine led to kidney function recovery.

Implications:

  • Monitoring kidney function in patients taking clozapine is essential.
  • Prompt diagnosis and removal of the offending drug can prevent acute kidney injury.
  • This case highlights the importance of considering clozapine as a potential cause of AIN in psychiatric patients.