ADAM L. LINTON, M.B.; WILLIAM F. CLARK, M.D.; ALBERT A. DRIEDGER, M.D.; D. IAN TURNBULL, M.D.; ROBERT M. LINDSAY, M.D.
Acute interstitial nephritis due to drugs commonly presents as acute renal failure and may be commoner than is presently realized. Drugs implicated include not only methicillin and other penicillins but also diuretics and nonsteroidal anti-inflammatory agents. The mechanism of injury likely involves an immunologic disturbance, possibly a delayed hypersensitivity reaction. Differential diagnosis from other causes of acute renal failure may be difficult, but coincident evidence of an acute allergic reaction may help, as may the detection of eosinophils in the urine or avid uptake of 67Ga by the kidneys. Definitive diagnosis may require renal biopsy, which will reveal normal glomeruli and a patchy but usually heavy interstitial infiltrate with lymphocytes, plasma cells, and eosinophils. Diagnosis of acute interstitial nephritis is important, because withdrawal of the offending agent will usually result in rapid improvement in renal function, and steroid therapy may reduce residual chronic renal damage.
LINTON AL, CLARK WF, DRIEDGER AA, TURNBULL DI, LINDSAY RM. Acute Interstitial Nephritis Due to Drugs: Review of the Literature with a Report of Nine Cases. Ann Intern Med. 1980;93:735–741. doi: 10.7326/0003-4819-93-5-735
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Published: Ann Intern Med. 1980;93(5):735-741.
Acute Kidney Injury, Hospital Medicine, Nephrology.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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