Caused by acute inflammation of the renal interstitium, most probably mediated by a hypersensitivity reaction.
Usually triggered by an offending medication, of which >100 are known. Also occurs in chronic inflammatory disease.
Presents with acute renal failure and the 'hypersensitivity triad' of rash, fever, and eosinophilia. Nephrotic syndrome may also be present in cases triggered by non-steroidal anti-inflammatory drugs.
Usually resolves once the offending medication is discontinued.
Treatment is largely supportive, with management of fluid electrolyte balance and fluid retention. Corticosteroid therapy may be given to increase the rate and extent of renal functional recovery.
Prognosis is good, although most patients have some residual renal impairment.
Consultant Nephrologist and Joint Medical Director
Epsom & St Helier Hospitals
JM declares that he has no competing interests.
Dr James Marsh would like to gratefully acknowledge Dr Alice Appel, Dr Gerald Appel and and Dr Kate Shiell, previous contributors to this monograph. AA, GA and KS declare that they have no competing interests.
Chicago Medical School
Rosalind Franklin University
IM declares that he has no competing interests.
CC declares that she has no competing interests.
Consultant Nephrologist/Lead Clinician
Glasgow Royal Infirmary
NHS Greater Glasgow and Clyde
RM declares that he has no competing interests.
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