What are the causes of chronic interstitial nephritis?

Causes of chronic interstitial nephritis:

The same causes are also applied for chronic tubulointerstitial nephritis.


Unresolved acute interstitial nephritis:

  • Any causes of acute interstitial nephritis, if persist for a longer period

Inflammatory glomerulonephritis

  • In most types of inflammatory glomerulonephritis, the inflammation spreads to the interstitium.

Toxic

  • Aristolochia in herbal medicines
  • Lead
  • Balkan nephropathy
  • Herbal nephropathy
  • Mushrooms (Cortinarius)

Drugs

  • All drugs causing acute interstitial nephritis
  • Tenofovir
  • Lithium toxicity
  • Analgesic nephropathy
  • Ciclosporin, tacrolimus
  • 5-aminosalicylates

Infection

  • Consequence of severe pyelonephritis
  • Human immunodeficiency virus
  • Epstein–Barr virus

Metabolic conditions:

  • Calcium phosphate crystallization after excessive phosphate administration (e.g. phosphate enemas in patients with chronic kidney disease)
  • Hypokalaemia
  • Hyperoxaluria
  • Nephrocalcinosis

In other systemic diseases:

  • Diabetes mellitus
  • Hypertension
  • Sickle cell disease or trait
  • Systemic lupus erythematosus/vasculitis
  • Sjögren’s syndrome
  • Sarcoidosis
  • IgG4-related disease
  • Alport’s syndrome

Congenital/developmental

  • Vesico-ureteric reflux: associated but causation not clear
  • Renal dysplasias: often associated with reflux
  • Inherited: now well recognised but mechanisms unclear
  • Other: Wilson’s disease, sickle-cell nephropathy, medullary sponge kidney (nephrocalcinosis)
This image is made with canva

Source:

  • Davidson: 403
  • Kumar and Clark: 1386

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