Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- use of triggering medication
- loss of kidney function
- fever
- rash
- edema
- decreased urinary volume
Otros factores de diagnóstico
- arthralgia
- uveitis
Factores de riesgo
- use of a triggering medication
- age >65 years
- chronic inflammatory disease
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- 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
Pruebas diagnósticas que deben considerarse
- kidney ultrasound
- kidney biopsy
- kidney gallium scan
- urine cytokines
Algoritmo de tratamiento
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
Divulgaciones
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
Divulgaciones
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.
Agradecimientos
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.
Divulgaciones
JM, AA, GA, and KS declare that they have no competing interests.
Revisores por pares
Irfan Moinuddin, MD
Assistant Professor
Chicago Medical School
Rosalind Franklin University
Lombard
IL
Divulgaciones
IM declares that he has no competing interests.
Catherine Clase, BA, MB, MSC, FRCPC
Associate Professor
Nephrologist
McMaster University
Hamilton
Ontario
Canada
Divulgaciones
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
Divulgaciones
RM declares that he has no competing interests.
Agradecimiento de los revisores por pares
Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.
Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
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
- Acute glomerulonephritis
- Acute tubular necrosis
- Acute vascular injury
Mais Diagnósticos diferenciaisDiretrizes
- ACR appropriateness criteria: renal failure
- Acute kidney injury: prevention, detection and management
Mais DiretrizesConectar-se ou assinar para acessar todo o BMJ Best Practice
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