Interstitial nephritis
Definition
Interstitial nephritis is a kidney disorder in which the spaces between the kidney tubules become swollen (inflammed). The inflammation can affect the kidneys' ability to filter waste.
Alternative Names
Tubulointerstitial nephritis; Nephritis - interstitial; Acute interstitial (allergic) nephritisCauses
Interstitial nephritis may be temporary (acute) or it may be chronic and get worse over time.
The following can cause interstitial nephritis:
- Allergic reaction to a drug (acute interstitial allergic nephritis)
- Analgesic nephropathy
- Side effect of certain antibiotics (penicillin, ampicillin, methicillin, sulfonamide medications, and others)
- Side effect of medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), furosemide, and thiazide diuretics
The acute form of interstitial nephritis is common. It is most often caused by side effects of certain drugs. This disorder may be more severe and more likely to lead to chronic or permanent kidney damage in elderly people.
Symptoms
Interstitial nephritis can cause mild to severe kidney problems, including acute kidney failure. In about half of cases, people will have decreased urine output and other signs of acute kidney failure.
Symptoms of this condition include:
- Blood in the urine
- Fever
- Increased or decreased urine output
- Mental status changes (drowsiness, confusion, coma)
- Nausea, vomiting
- Rash (sometimes)
- Swelling of the body, any area
- Weight gain (from retaining fluid)
Exams and Tests
An exam may show edema or too much fluid. The health care provider might hear abnormal sounds when listening to the heart or lungs with a stethoscope (auscultation). Blood pressure commonly is high.
Common tests include:
- Arterial blood gases and blood chemistry
- BUN and creatinine levels
- Complete blood count
- Kidney biopsy
- Red blood cell count - urine
- Urinalysis
- Urine pH
- Urine specific gravity and osmolality
- White blood cell count
Treatment
Treatment focuses on the cause of the problem. Avoiding medications that lead to this condition may relieve the symptoms quickly.
Limiting salt (sodium) and fluid in the diet can control swelling and high blood pressure . Also limiting protein can help control the buildup of waste products in the blood (azotemia) that can lead to acute kidney failure.
If dialysis is necessary, it usually is required for only a short time.
Corticosteroids or anti-inflammatory medications can help in some cases.
Outlook (Prognosis)
Most often, interstitial nephritis is a short-term disorder. In rare cases, it can cause permanent damage, including chronic kidney failure.
Possible Complications
Metabolic acidosis can occur because the kidneys aren't able to remove enough acid. The disorder can lead to acute or chronic kidney failure or end-stage kidney disease.
When to Contact a Medical Professional
Call your health care provider if you have symptoms of interstitial nephritis.
If you have interstitial nephritis, call your health care provider if you get new symptoms, especially if you are less alert or have a decrease in urine output.
Prevention
In many cases, the disorder can't be prevented. Avoiding or reducing your use of medications that can cause this condition can help reduce your risk.
Reviewed By: Charles Silberberg, DO, Private Practice specializing in Nephrology, Affiliated with NY Medical College, Division of Nephrology, Valhalla, NY. Review provided by VeriMed Healthcare Network.
