Acute Interstitial Nephritis (AIN)

WHAT IS IT?

Acute interstitial nephritis refers to a particular subset of nephritis, specifically inflammation of the interstitium of the kidneys that surround the tubules that has an acute onset. 

WHAT CAUSES IT?

Here are the following categories of things that can cause this condition:

  • Medication usage: penicillin, cephalosporins, sulfonamides
  • Infection 
WHY IS IT CONCERNING MEDICALLY?

This condition can result in permanent damage to the kidneys. 

WHAT IS THE INTIAL PRESENTATION?

Patient Chief Complaints:

  • Fever 
  • Blood in urine
  • Joint pain
  • Rash

Detected Medical Problems:

  • Hematuria
  • Elevated creatinine 
WHAT ARE IMPORTANT ELEMENTS OF THE MEDICAL HISTORY?

Risk Factors:

  • Recent antibiotic usage: penicillins, cephalosporins, sulfonamides

Medical History:

 

WHAT ARE IMPORTANT FEATURES OF THE PHYSICAL EXAM?

Vital Signs:

 

Other:

 

CLINICAL WORKUP: SERUM STUDIES

BMP/CMP:

  • Elevated creatinine: 
CLINICAL WORKUP: URINE STUDIES

Urinalysis:

  • Hematuria: increases RBCs can be present in the urine 
  • White blood cell cases: can be observed on microscopy 
  • Eosinophiluria can be present as well. 
CLINICAL WORKUP: IMAGING

 

CLINICAL WORKUP: OTHER

 

HOW DO WE NARROW THE DIFFERENTIAL?

Conditions that present similarly and how to exclude them:

 

WHAT IS OUR THRESHOLD FOR DIAGNOSING THIS CONDITION?

 

PATIENT MANAGMENT: SYMPTOM RELEIF

 

PATIENT MANAGEMENT: DISEASE TREATMENT

Discontinue the offending agent: if drug indued 

PATIENT MANAGEMENT: PROPHYLACTIC MEASURES

 

COULD THIS HAVE BEEN PREVENTED?

 

ARCHIVE OF STANDARDIZED EXAM QUESTIONS 

This archive compiles standardized exam questions that relate to this topic.

 

Page Updated: 02.13.2017