What are the causes of chronic interstitial nephritis?

Causes of chronic interstitial nephritis:

The same causes are also applied to 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 recognized 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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  7. The etiology of interstitial nephritis determines the course of treatment. Drug withdrawal may be the sole therapy required when AIN is brought on by a drug allergy. Anti-inflammatory drugs can be used to treat more cases of AIN. A complete recovery is generally achieved with prompt treatment. Before interstitial nephritis is identified, the kidneys may occasionally sustain irreversible damage. Additionally, this injury has to be treated. Eliminating salt from your diet might help with high blood pressure and water retention. An improved kidney function may also result from eating a low-protein diet. Dialysis could be required if your condition is severe in order to maintain kidney function. Kidney failure patients can require a transplant.

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