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Hypersensitivity Nephropathy Follow-up

  • Author: Micah L Thorp, DO, MPH; Chief Editor: Vecihi Batuman, MD, FACP, FASN  more...
 
Updated: Dec 01, 2015
 

Further Outpatient Care

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  • Most cases of acute interstitial nephritis (AIN) are diagnosed in the hospital setting. Carefully monitor renal function until resolved.
  • Make patients aware of any drug that may have caused the episode of acute interstitial nephritis, and advise them not to take it again.
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Prognosis

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  • If acute interstitial nephritis is detected early and the offending agent is removed, the patient will most likely return to baseline renal function. If the diagnosis is overlooked or if the patient is rechallenged with the same offending agent, the initial inflammatory response may become chronic, leading to fibrosis and tubular atrophy.
  • The prognosis is further delineated by the pathology found at biopsy. Patients with a diffuse infiltrate have a poorer prognosis than those without. In addition, the presence of 1-6% neutrophils in the infiltrate suggests a poorer prognosis.
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Patient Education

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  • Educate patients about agents that lead to acute interstitial nephritis, and instruct them to avoid using the offending agents.
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Contributor Information and Disclosures
Author

Micah L Thorp, DO, MPH Consulting Staff, Department of Nephrology, Lake Road Nephrology Center, Northwest Permanente Medical Group

Micah L Thorp, DO, MPH is a member of the following medical societies: American College of Physicians, American Society of Nephrology, American Medical Association, National Kidney Foundation

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Ajay K Singh, MB, MRCP, MBA Associate Professor of Medicine, Harvard Medical School; Director of Dialysis, Renal Division, Brigham and Women's Hospital; Director, Brigham/Falkner Dialysis Unit, Faulkner Hospital

Disclosure: Nothing to disclose.

Chief Editor

Vecihi Batuman, MD, FACP, FASN Huberwald Professor of Medicine, Section of Nephrology-Hypertension, Tulane University School of Medicine; Chief, Renal Section, Southeast Louisiana Veterans Health Care System

Vecihi Batuman, MD, FACP, FASN is a member of the following medical societies: American College of Physicians, American Society of Hypertension, American Society of Nephrology, International Society of Nephrology

Disclosure: Nothing to disclose.

Additional Contributors

Chike Magnus Nzerue, MD, FACP Professor of Medicine, Associate Dean for Clinical Affairs, Meharry Medical College

Chike Magnus Nzerue, MD, FACP is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American College of Physicians-American Society of Internal Medicine, American Society of Nephrology, National Kidney Foundation

Disclosure: Nothing to disclose.

References
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  7. Gonzalez E, Gutierrez E, Galeano C, et al. Early steroid treatment improves the recovery of renal function in patients with drug-induced acute interstitial nephritis. Kidney Int. 2008 Apr. 73(8):940-6. [Medline].

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  9. Councilman WT. Acute interstitial nephritis. Journal of Experimental Medicine. 1898. 3:393-420.

  10. Fried T. Acute interstitial nephritis. Why do the kidneys suddenly fail?. Postgrad Med. 1993 Apr. 93(5):105-6, 111-2, 117-20. [Medline].

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  14. Ruffing KA, Hoppes P, Blend D, et al. Eosinophils in urine revisited. Clin Nephrol. 1994 Mar. 41(3):163-6. [Medline].

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Acute interstitial nephritis with mononuclear cell infiltrate.
Mononuclear cell infiltrate between tubules.
 
 
 
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