Interstitial nephritis natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Prognosis

The kidneys are the only body system that is directly affected by tubulointerstitial nephritis. Kidney function is usually reduced; the kidneys can be just slightly dysfunctional, or fail completely.

In chronic tubulointerstitial nephritis the most serious long term effect is kidney failure. When the proximal tubule is injured sodium, potassium, bicarbonate, uric acid, and phosphate intake may be reduced or changed, resulting in low bicarbonate, known as metabolic acidosis, hypokalemia, low uric acid (hypouricemia, and low phosphate (hypophosphatemia). Damage to the distal renal tubule may cause loss of urine concentrating ability and polyuria.

In most cases of acute tubulointerstitial nephritis, the function of the kidneys will return after the harmful drug is not taken anymore, or when the underlying disease is cured by treatment. If the illness is caused by an allergic reaction, a corticosteroid may speed the recovery kidney function, however this is often not the case. Chronic tubulointerstitial nephritis has no cure. Some patients may require dialysis. Eventually, a kidney transplant may be needed.