What are the causes of acute interstitial nephritis (AIN)?

by - Mohammad Hafiz on - September 03, 2021

Causes of acute interstitial nephritis (AIN):

As tubular and interstitial injury and recovery tend to go hand in hand, it is often called acute tubulointerstitial nephritis (acute TIN). The causes are the same in both terms.

Drugs (70%):

  • Antibiotics: Cephalosporins, Ciprofloxacin, Erythromycin, Penicillin, Rifampicin, Sulphonamides
  • Analgesics: non-steroidal anti-inflammatory drugs
  • Diuretics: furosemide, thiazides
  • Miscellaneous: Proton pump inhibitors, allopurinol, carbamazepine, cimetidine, phenytoin, valproate, Mesalazine (delayed)

Infection (15%):

  • Bacterial pyelonephritis due to Legionella, Leptospira, streptococci, Mycoplasma,
  • Brucella, Chlamydia
  • Viruses: Hantavirus, Epstein–Barr virus, HIV, measles, adenovirus
  • Others: Tuberculosis, Leptospirosis, Leishmania, Toxoplasma
  • In immunocompromised patients (e.g. in transplanted patients): Cytomegalovirus, polyoma (BK) and herpes simplex

Immune:

  • Tubulointerstitial nephritis with uveitis (TINU) (5%)
  • Transplant rejection

With other multi-system disorders:

  • Systemic inflammatory disorders, e.g. Systemic lupus erythematosus (2%), IgG4-related disorder, Sjögren’s syndrome
  • Sarcoidosis
  • Sickle cell crisis

Toxic:

  • Lead poisoning
  • Myeloma light chains
  • Mushrooms (Cortinarius)

Idiopathic (8%)

acute interstitial nephritis

Source:

  • Kumar and Clark; 10th Edition: 1385
  • Davidson 23rd: 402
  • Sanjay Sharma: Q 317
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3 Comments

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  3. Eva HoldenAugust 31, 2026 at 6:51 PM

    This is a clear explanation of the usual causes of acute interstitial nephritis. It pays special attention to drugs and infections, and it explains why they matter. I could follow the points without much effort. The way the process is laid out helped me see how the condition starts and develops. It also made me think about how careful study can turn a hard topic into something easier to grasp. That feels a bit like looking at Business Management Dissertation Topics in different ways.

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