Acute interstitial nephritis
This is an immune reaction to drugs or infection.
It accounts for 2% of all acute renal failure but 25% of drug-induced renal failure.
- acute renal failure
- systemic symptoms
- eosinophilia, raised IgE
>1% urinary eosinophils suggests diagnosis
Renal biopsy would show infiltration of the renal interstitium with:
- T lymphocytes
- plasma cells
- infections: hanta virus, leptospirosis, mycobacterium, staph, strep
- drugs: methicillin, NSAIDs, rifampacin, allopurinol, penicillin, cephalosporins, furosemide, thiazides, amphotericin, aspirin
Lets move on to consider a hat-trick of causes of chronic interstitial nephritis