Interstitial nephritis causes
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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
(with antibiotics responsible for 30 to 49 percent of these cases) – 70
to 75 percent
Any drug has 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:
- 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
- Ciprooxacin 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 includings bacterial viral fungal parasitic infections.
Bacteria
- Legionella,
- Leptospira,
- Streptococcus,
- Mycobacterium tuberculosis,
- Corynebacterium diphtheriae
- Yersinia,
- Enterococcus
- Escherichia coli
Virus
- cytomegalovirus (CMV)
- Epstein-Barr virus (EBV),
- polyomavirus,
- 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)