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Acute interstitial nephritis

Última revisão: 12 Dec 2025
Última atualização: 04 Apr 2023

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • use of triggering medication
  • loss of kidney function
  • fever
  • rash
  • edema
  • decreased urinary volume
Detalhes completos

Outros fatores diagnósticos

  • arthralgia
  • uveitis
Detalhes completos

Fatores de risco

  • use of a triggering medication
  • age >65 years
  • chronic inflammatory disease
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • serum creatinine and blood urea nitrogen (BUN)
  • CBC with WBC differential
  • urinalysis
  • trial of discontinuing triggering medication
  • antineutrophil cytoplasmic antibody (ANCA)
  • antinuclear antibody (ANA)
  • anti-double stranded DNA (anti-ds DNA)
  • complement profile
Detalhes completos

Investigações a serem consideradas

  • kidney ultrasound
  • kidney biopsy
  • kidney gallium scan
  • urine cytokines
Detalhes completos

Algoritmo de tratamento

AGUDA

medication related

chronic inflammatory disease related

Colaboradores

Autores

Mark A. Perazella, MD, FACP

Professor of Medicine (Nephrology)

Section of Nephrology

Department of Internal Medicine

Yale School of Medicine

New Haven

CT

Declarações

MAP declares that he has no competing interests. MAP is an author of several references cited in this topic.

Dennis G. Moledina, MBBS, PhD, FASN

Assistant Professor of Medicine (Nephrology)

Department of Internal Medicine (Section of Nephrology)

Clinical and Translational Research Accelerator

Yale School of Medicine

New Haven

CT

Declarações

DGM (via his employer Yale University) has received a grant from the National Institutes of Health and National Institute of Diabetes & Digestive & Kidney Diseases as an investigator (K23DK117065, R01DK128087, and R01DK126815). He is co-inventor of the pending patent application (number 16/536718), "System and methods for diagnosing acute interstitial nephritis." He serves on the board of "Predict AIN, LLC" and has received honorarium from National Kidney Foundation. DGM is an author of several references cited in this topic.

Agradecimentos

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.

Declarações

JM, AA, GA, and KS declare that they have no competing interests.

Revisores

Irfan Moinuddin, MD

Assistant Professor

Chicago Medical School

Rosalind Franklin University

Lombard

IL

Declarações

IM declares that he has no competing interests.

Catherine Clase, BA, MB, MSC, FRCPC

Associate Professor

Nephrologist

McMaster University

Hamilton

Ontario

Canada

Declarações

CC declares that she has no competing interests.

Robert Mactier, MD, FRCP

Consultant Nephrologist/Lead Clinician

Renal Unit

Glasgow Royal Infirmary

NHS Greater Glasgow and Clyde

Glasgow

UK

Declarações

RM declares that he has no competing interests.

Créditos aos pareceristas

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Referências

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Principais artigos

Raghavan R, Eknoyan G. Acute interstitial nephritis - a reappraisal and update. Clin Nephrol. 2014 Sep;82(3):149-62.Texto completo  Resumo

Praga M, Sevillano A, Auñón P, et al. Changes in the aetiology, clinical presentation and management of acute interstitial nephritis, an increasingly common cause of acute kidney injury. Nephrol Dial Transplant. 2015 Sep;30(9):1472-9.Texto completo  Resumo

Moledina DG, Eadon MT, Calderon F, et al. Development and external validation of a diagnostic model for biopsy-proven acute interstitial nephritis using electronic health record data. Nephrol Dial Transplant. 2022 Oct 19;37(11):2214-22.Texto completo  Resumo

Moledina DG, Perazella MA. Drug-induced acute interstitial nephritis. Clin J Am Soc Nephrol. 2017 Dec 7;12(12):2046-9.Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Diagnósticos diferenciais

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  • Diretrizes

    • ACR appropriateness criteria: renal failure
    • Acute kidney injury: prevention, detection and management
    Mais Diretrizes
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