Tubulointerstitial Nephritis

Posted by e-Medical PPT Saturday, November 6, 2010
Tubulointerstitial nephritis is inflammation that affects the tubules of the kidneys and the tissues that surround them.Tubulointerstitial nephritis may be acute or chronic, and it often results in kidney failure. It may be caused by various diseases, drugs, toxins, or radiation that damages the kidneys. Damage to the tubules results in changes in the concentrations of electrolytes in the blood or in problems with the kidney's ability to concentrate urine. There are two parts of the kidney tubules, the proximal and the distal. When the proximal tubule is damaged, the normal reabsorption into the blood of sodium, potassium, bicarbonate, uric acid, and phosphate may be altered, resulting in low levels in the blood of these substances. Injuries to the distal tubule are usually associated with a loss of urine-concentrating ability and polyuria.
The most common cause of acute tubulointerstitial nephritis is an allergic reaction to a drug. Antibiotics such as penicillin and the sulfonamides, diuretics, and nonsteroidal anti-inflammatory drugs (NSAIDs)—including aspirin —may trigger an allergic reaction.
Drugs can also cause tubulointerstitial nephritis through nonallergic mechanisms also.
Pyelonephritis can also cause acute or chronic tubulointerstitial nephritis.
Kidney function usually improves when an offending drug is discontinued or treatment of the underlying disease is effective, although some kidney scarring is common. Treatment with a corticosteroid may speed the recovery of kidney function when the disorder is caused by an allergic reaction. If kidney function worsens and kidney failure develops, dialysis is usually needed. In some cases, the damage is irreversible, and kidney failure becomes chronic.

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