Last reviewed: June 2020
Last updated: January  2020

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • fever
  • rash
  • oedema
  • decreased urinary volume

Risk factors

  • use of a triggering medication
  • age
  • chronic inflammatory disease

Diagnostic investigations

1st investigations to order

  • serum urea and creatinine
  • FBC with WBC differential
  • urinalysis
  • trial of discontinuing offending medication
  • anti-neutrophil cytoplasmic antibody (ANCA)
  • anti-nuclear antibody (ANA)
  • anti-double stranded DNA (anti-ds DNA)
  • complement profile
More 1st investigations to order

Investigations to consider

  • kidney ultrasound
  • kidney biopsy
  • kidney gallium scan
  • urine cytokines
More investigations to consider

Treatment algorithm

Contributors

Professor of Medicine (Nephrology)

Section of Nephrology

Department of Internal Medicine

Yale School of Medicine

New Haven

CT

Disclosures

MAP declares that he has no competing interests.

Assistant Professor of Medicine (Nephrology)

Yale Program of Applied Translational Research

Department of Internal Medicine

Yale School of Medicine

New Haven

CT

Disclosures

DGM has received a grant from the National Institutes of Health (K23DK-117065), focusing on biomarkers of acute interstitial nephritis, and is supported by the Yale O'Brien Center, focusing on subclinical acute interstitial nephritis. He has a provisional patent application (co-inventor) for provisional patent number 62/716,465, "System and methods for diagnosing acute interstitial nephritis".

Prof. Mark A. Perazella and Dr Dennis G. Moledina would like to gratefully acknowledge Dr James Marsh, Dr Alice Appel, Dr Gerald Appel, and Dr Kate Shiell, previous contributors to this topic.

Peer reviewersVIEW ALL

Assistant Professor

Chicago Medical School

Rosalind Franklin University

Lombard

IL

Disclosures

IM declares that he has no competing interests.

Associate Professor

Nephrologist

McMaster University

Hamilton

Ontario

Canada

Disclosures

CC declares that she has no competing interests.

Consultant Nephrologist/Lead Clinician

Renal Unit

Glasgow Royal Infirmary

NHS Greater Glasgow and Clyde

Glasgow

UK

Disclosures

RM declares that he has no competing interests.

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