Interstitial nephritis causes

	Interstitial nephritis Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohsen Basiri M.D.

Overview

Common causes of interstitial nephritis include drug side effects, particularly analgesics and antibiotics. Other common causes include associated nephrologic conditions, as well as microbial infections.

Causes

Drugs

70 to 75 percent (with antibiotics responsible for 30 to 49 percent of these cases)^[1]

Any drug has the potentiality to cause AIN, among case reports of many drugs causing AIN, but only a few have been reported with biopsy-proven AIN. The most common proven drugs cause of AIN include:^[2]^[3]^[4]^[5]^[6]^[7]

Nonsteroidal anti-inflammatory agents (NSAIDs)

Penicillins and cephalosporins
Antimicrobial sulfonamides, including trimethoprim-sulfamethoxazole
Rifampin
Diuretics, including loop diuretics such as furosemide and bumetanide, and
Thiazide-type diuretics
Ciprofloxacin and, perhaps to a lesser degree, ● other quinolones
Cimetidine
Allopurinol
Proton pump inhibitors such as omeprazole and lansoprazole
Indinavir
5-aminosalicylates (eg, mesalamine)

Infections

Multiple organisms may cause TIN including bacterial viral fungal parasitic infections.^[8]^[9]^[10]^[11]^[12]^[13]

Bacteria

Legionella,
Leptospira,
Streptococcus,
Mycobacterium tuberculosis,
Corynebacterium diphtheriae
Yersinia,
Enterococcus
Escherichia coli

Virus

Cytomegalovirus (CMV)
Epstein-Barr virus (EBV),
Aolyomavirus,
Adenovirus,
Candida

parasites

Leishmania
Toxoplasma

Immunologic diseases

Sarcoidosis

SLE,

Sjögren's syndrome

Tubulointerstitial nephritis and uveitis (TINU) syndrome – 5 to 10 percent

Less Common Causes

Less common causes of TIN include:

Heavy metals (eg, lead, cadmium, mercury)
Obstructive uropathy, nephrolithiasis, reflux disease
Neoplasia (eg, myeloma, leukemia, amyloidosis)
Metabolic diseases (eg, hypercalcemia, cystinosis, potassium depletion, hyperoxaluria)

Cardiovascular	Granulomatosis with polyangiitis, Kawasaki's disease
Chemical/Poisoning	Aristolochia, Quinine, Thiazide diuretics
Dental	No underlying causes
Dermatologic	Rubeola infection,
Drug Side Effect	Acetaminophen , Acyclovir, Aldomet, Allopurinol, Alpha-interferon, Amlodipine, Ampicillin, Anitrim, Anti-tubular basement membrane antibodies , Apo-sulfatrim, Aspirin, Azathioprine, Bactelan, Batrizol, Bumetanide, Captopril, Carbamazepine, Cefaclor, Cefotaxime sodium, Cefoxitin sodium, Cephalosporin, Chlorthalidone, Cimetidine , Ciprofloxacin, Clofibrate, Cox-2 inhibitors, Creatine, Dabrafenib mesylate, Diazepam, Diclofenac, Diflunisal, Diltiazem, Diphenylhydantoin, Diuretics, Doxycycline, Ectaprim, Enterobacticel, Erythromycin, Esteprim, Ethambutol, Famotidine, Fenoprofen, Flurbiprofen, Furosemide, Griseofulvin, Hydralazine, Hydrochlorothiazide, Ibuprofen, Indinavir, Indomethacin, Isobac, Isoniazid, Kelfiprim, Ketoprofen, Lansoprazole, Macrolides, Mesalamine, Mesalazine, Methicillin, Metoxiprim, Minocycline hydrochloride, Naproxen, Novo-trimel, Nu-cotrimox, Olsalazine, Omeprazole, Oxacillin, Oxaprozin, Oxytetracycline, Pegylated interferon alfa-2b, Penicillin , Phenindione, Phenobarbital, Phenteramine, Phenylpropanolamine, Phenytoin, Piperacillin/tazobactam, Piroxicam, Polymyxin, Pranlukast, Propylthioruacil, Pro-trin, Rabeprazole, Ranitidine, Rifampin, Roubac, Streptomycin, Sulfatrim ds, Sulfinpyrazone, Sulfonamide, Sulfoxaprim, Sulindac, Syraprim, Tenofovir disoproxil fumarate, Tetracycline, Thiazide diuretics, Tolmetin, Treponema, Triamterene, Trimesuxol, Trimethoprim-sulfamethoxazole, Trimetoger, Trimetox, Trimzol, Trisulfa, Trisulfam, Uroplus ds, Uroplus ss, Vancomycin
Ear Nose Throat	Sjogren syndrome
Endocrine	No underlying causes
Environmental	No underlying causes
Gastroenterologic	Escherichia coli, Inflammatory bowel disease
Genetic	Alport syndrome, Bardet-biedl syndrome
Hematologic	Hypercalcemia, Hyperkalaemic distal renal tubular acidosis, Hyperuricemia, Hypokalemia, Sickle cell disease
Iatrogenic	No underlying causes
Infectious Disease	Adenovirus, Brucella, Candida, Chlamydia, Coccidioidomycosis, Corynebacterium diphtheriae, Cytomegalovirus, Diphtheria, Enterococcus, Epstein-barr virus , Escherichia coli, Francisella, Hantaan virus, Histoplasmosis, Hiv infection, Legionellosis, Leishmaniasis, Leptospirosis, Mycobacterium tuberculosis, Mycoplasma infection, Polyomavirus, Rickettsia infection, Rubeola infection, Streptococcal infection, Syphilis, Toxoplasmosis, Uveitis, Yersinia
Musculoskeletal/Orthopedic	No underlying causes
Neurologic	No underlying causes
Nutritional/Metabolic	Creatine, Hyperuricemia, Hypokalemia
Obstetric/Gynecologic	No underlying causes
Oncologic	Myeloma
Ophthalmologic	Uveitis
Overdose/Toxicity	Cocaine
Psychiatric	No underlying causes
Pulmonary	Hantaan virus, Histoplasmosis, Sarcoidosis
Renal/Electrolyte	Alport syndrome, Granulomatosis with polyangiitis, Hyperkalaemic distal renal tubular acidosis, Reflux nephropathy, Renal failure, Sensenbrenner syndrome, Tubulointerstitial nephritis, Wegener's granulomatosis
Rheumatology/Immunology/Allergy	Igg4-related disease, Kawasaki's disease, Sarcoidosis, Sicca syndrome, Systemic lupus erythematosus
Sexual	Hiv infection, Syphilis
Trauma	No underlying causes
Urologic	No underlying causes
Miscellaneous	No underlying causes

Causes in Alphabetical Order

3

References

↑ Baker, R. J.; Pusey, C. D. (2004). "The changing profile of acute tubulointerstitial nephritis". Nephrology Dialysis Transplantation. 19 (1): 8–11. doi:10.1093/ndt/gfg464. ISSN 0931-0509.
↑ Neilson EG. Pathogenesis and therapy of interstitial nephritis. Kidney Int 1989; 35:1257
↑ Ten RM, Torres VE, Milliner DS, et al. Acute interstitial nephritis: immunologic and clinical aspects. Mayo Clin Proc 1988; 63:921
↑ Michel DM, Kelly CJ. Acute interstitial nephritis. J Am Soc Nephrol 1998; 9:506
↑ Michel DM, Kelly CJ. Acute interstitial nephritis. J Am Soc Nephrol 1998; 9:506
↑ Torpey N, Barker T, Ross C. Drug-induced tubulo-interstitial nephritis secondary to proton pump inhibitors: experience from a single UK renal unit. Nephrol Dial Transplant 2004; 19:1441
↑ Wang YC, Lin YF, Chao TK, et al. Acute interstitial nephritis with prominent eosinophil in􀉹ltration. Clin Nephrol 2009; 71:187
↑ Kodner CM, Kudrimoti A. Diagnosis and management of acute interstitial nephritis. Am Fam Physician 2003; 67:2527
↑ Muriithi AK, Leung N, Valeri AM, et al. Biopsy-proven acute interstitial nephritis, 1993-2011: a case series. Am J Kidney Dis 2014; 64:558
↑ Chang JF, Peng YS, Tsai CC, et al. A possible rare cause of renal failure in streptococcal infection. Nephrol Dial Transplant 2011; 26:368
↑ Agrawal V, Crisi GM, D'Agati VD, Freda BJ. Renal sarcoidosis presenting as acute kidney injury with granulomatous interstitial nephritis and vasculitis. Am J Kidney Dis 2012; 59:303
↑ Farr RW. Leptospirosis. Clin Infect Dis 1995; 21:1.
↑ Baksh FK, Finkelstein SD, Swalsky PA, et al. Molecular genotyping of BK and JC viruses in human polyomavirus-associated interstitial nephritis after renal transplantation. Am J Kidney Dis 2001; 38:354

Template:WH Template:WS

[BakerPusey2004-1] Baker, R. J.; Pusey, C. D. (2004). "The changing profile of acute tubulointerstitial nephritis". Nephrology Dialysis Transplantation. 19 (1): 8–11. doi:10.1093/ndt/gfg464. ISSN 0931-0509.

[2] Neilson EG. Pathogenesis and therapy of interstitial nephritis. Kidney Int 1989; 35:1257

[3] Ten RM, Torres VE, Milliner DS, et al. Acute interstitial nephritis: immunologic and clinical aspects. Mayo Clin Proc 1988; 63:921

[4] Michel DM, Kelly CJ. Acute interstitial nephritis. J Am Soc Nephrol 1998; 9:506

[5] Michel DM, Kelly CJ. Acute interstitial nephritis. J Am Soc Nephrol 1998; 9:506

[6] Torpey N, Barker T, Ross C. Drug-induced tubulo-interstitial nephritis secondary to proton pump inhibitors: experience from a single UK renal unit. Nephrol Dial Transplant 2004; 19:1441

[7] Wang YC, Lin YF, Chao TK, et al. Acute interstitial nephritis with prominent eosinophil in􀉹ltration. Clin Nephrol 2009; 71:187

[8] Kodner CM, Kudrimoti A. Diagnosis and management of acute interstitial nephritis. Am Fam Physician 2003; 67:2527

[9] Muriithi AK, Leung N, Valeri AM, et al. Biopsy-proven acute interstitial nephritis, 1993-2011: a case series. Am J Kidney Dis 2014; 64:558

[10] Chang JF, Peng YS, Tsai CC, et al. A possible rare cause of renal failure in streptococcal infection. Nephrol Dial Transplant 2011; 26:368

[11] Agrawal V, Crisi GM, D'Agati VD, Freda BJ. Renal sarcoidosis presenting as acute kidney injury with granulomatous interstitial nephritis and vasculitis. Am J Kidney Dis 2012; 59:303

[12] Farr RW. Leptospirosis. Clin Infect Dis 1995; 21:1.

[13] Baksh FK, Finkelstein SD, Swalsky PA, et al. Molecular genotyping of BK and JC viruses in human polyomavirus-associated interstitial nephritis after renal transplantation. Am J Kidney Dis 2001; 38:354

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