Interstitial nephritis
Tubulointerstitial nephritis; Nephritis - interstitial; Acute interstitial (allergic) nephritisInterstitial nephritis is a kidney disorder in which the spaces between the kidney tubules become swollen (inflamed). This can cause problems with the way your kidneys work.
Causes
Interstitial nephritis may be temporary (acute), or it may be long-lasting (chronic) and get worse over time.
Acute
Acute means sudden. Acute symptoms appear, change, or worsen rapidly. It is the opposite of chronic.
Read Article Now Book Mark ArticleChronic
Chronic refers to something that continues over an extended period of time. A chronic condition is usually long-lasting and does not easily or quick...
Read Article Now Book Mark ArticleThe acute form of interstitial nephritis is most often a side effect of certain drugs.
The following can cause interstitial nephritis:
- Allergic reaction to a drug (acute interstitial allergic nephritis).
Allergic reaction
Allergic reactions are sensitivities to substances called allergens that come into contact with the skin, nose, eyes, respiratory tract, and gastroin...
Read Article Now Book Mark Article - Autoimmune disorders, such as anti-tubular basement membrane disease or Kawasaki disease.
Kawasaki disease
Kawasaki disease is a rare condition that involves inflammation of the blood vessels. It occurs in children.
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- Long-term use of medicines such as acetaminophen (Tylenol), aspirin, and nonsteroidal anti-inflammatory drugs (NSAIDs). This is called analgesic nephropathy.
Analgesic nephropathy
Analgesic nephropathy involves damage to one or both kidneys caused by overexposure to mixtures of medicines, especially over-the-counter pain medici...
Read Article Now Book Mark Article - Side effect of certain antibiotics such as penicillin, ampicillin, methicillin, and sulfonamide medicines.
- Side effect of other medicines such as furosemide, thiazide diuretics, omeprazole, triamterene, and allopurinol.
- Too little potassium in your blood.
- Too much calcium or uric acid in your blood.
Symptoms
Interstitial nephritis can cause mild to severe kidney problems, including acute kidney failure. In about half of cases, people will have decreased urine output and other signs of acute kidney failure.
Acute kidney failure
Acute kidney failure is the rapid (less than 2 days) loss of your kidneys' ability to remove waste and help balance fluids and electrolytes in your b...
Read Article Now Book Mark ArticleDecreased urine output
Decreased urine output means that you produce less urine than normal. Most adults make at least 500 milliliters of urine in 24 hours (a little over ...
Read Article Now Book Mark ArticleSymptoms of this condition may include:
- Blood in the urine
Blood in the urine
Blood in your urine is called hematuria. The amount may be very small and only detected with urine tests or under a microscope. In other cases, the...
Read Article Now Book Mark Article - Fever
Fever
Fever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...
Read Article Now Book Mark Article - Increased or decreased urine output
Decreased urine output
Decreased urine output means that you produce less urine than normal. Most adults make at least 500 milliliters of urine in 24 hours (a little over ...
Read Article Now Book Mark Article - Mental status changes (drowsiness, confusion, coma)
Mental status changes
Confusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembe...
Read Article Now Book Mark ArticleDrowsiness
Drowsiness refers to feeling more sleepy than normal during the day. People who are drowsy may fall asleep when they do not want to or at times whic...
Read Article Now Book Mark ArticleConfusion
Confusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembe...
Read Article Now Book Mark ArticleComa
Decreased alertness is a state of reduced awareness and is often a serious condition. A coma is the most severe state of decreased alertness from whi...
Read Article Now Book Mark Article - Nausea, vomiting
Nausea
Nausea is feeling an urge to vomit. It is often called "being sick to your stomach. "Vomiting or throwing-up forces the contents of the stomach up t...
Read Article Now Book Mark ArticleVomiting
Nausea is feeling an urge to vomit. It is often called "being sick to your stomach. "Vomiting or throwing-up forces the contents of the stomach up t...
Read Article Now Book Mark Article - Rash
Rash
Rashes involve changes in the color, feeling or texture of your skin.
Read Article Now Book Mark Article - Swelling of any area of body
Swelling
Swelling is the enlargement of organs, skin, or other body parts. It is caused by a buildup of fluid in the tissues. The extra fluid can lead to a ...
Read Article Now Book Mark Article - Weight gain (from retaining fluid)
Weight gain
Unintentional weight gain is when you gain weight without trying to do so and you are not eating or drinking more.
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Exams and Tests
Your health care provider will perform a physical exam. This may reveal:
- Abnormal lung or heart sounds
- High blood pressure
High blood pressure
Blood pressure is a measurement of the force exerted against the walls of your arteries as your heart pumps blood to your body. Hypertension is the ...
Read Article Now Book Mark Article - Fluid in the lungs (pulmonary edema)
Pulmonary edema
Pulmonary edema is an abnormal buildup of fluid in the lungs. This buildup of fluid leads to shortness of breath.
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Common tests include:
- Blood chemistry
Blood chemistry
A comprehensive metabolic panel is a group of blood tests. They provide an overall picture of your body's chemical balance and metabolism. Metaboli...
Read Article Now Book Mark Article - BUN and blood creatinine levels
BUN
BUN stands for blood urea nitrogen. Urea nitrogen is what forms when protein breaks down. A test can be done to measure the amount of urea nitrogen ...
Read Article Now Book Mark ArticleCreatinine
The creatinine blood test measures the level of creatinine in the blood. This test is done to see how well your kidneys are working. Creatinine in t...
Read Article Now Book Mark Article - Complete blood count
Complete blood count
A complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...
Read Article Now Book Mark Article - Kidney biopsy
Kidney biopsy
A kidney biopsy is the removal of a small piece of kidney tissue for examination.
Read Article Now Book Mark Article - Kidney ultrasound
- Urinalysis
Urinalysis
Urinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds th...
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Treatment
Treatment depends on the cause of the problem. Avoiding medicines that lead to this condition may quickly relieve symptoms.
Limiting salt and fluid in the diet can improve swelling and high blood pressure. Limiting protein in the diet can help control the buildup of waste products in the blood (azotemia), which can lead to symptoms of acute kidney failure.
Salt
Too much sodium in your diet can be bad for you. If you have high blood pressure or heart failure, you may be asked to limit the amount of salt (whi...
Read Article Now Book Mark ArticleProtein
Proteins are the building blocks of life. Every cell in the human body contains protein. The basic structure of protein is a chain of amino acids. ...
Read Article Now Book Mark ArticleAzotemia
Prerenal azotemia is an abnormally high level of nitrogen waste products in the blood.
Read Article Now Book Mark ArticleIf dialysis is necessary, it usually is required for only a short time.
Corticosteroids or stronger anti-inflammatory medicines such as cyclophosphamide can sometimes be helpful.
Outlook (Prognosis)
Most often, interstitial nephritis is a short-term disorder. In rare cases, it can cause permanent damage, including long-term (chronic) kidney failure.
Acute interstitial nephritis may be more severe and more likely to lead to long-term or permanent kidney damage in older people.
Kidney damage
Injury to the kidney and ureter is damage to the organs of the upper urinary tract.
Read Article Now Book Mark ArticlePossible Complications
Metabolic acidosis can occur because the kidneys aren't able to remove enough acid. The disorder can lead to acute or chronic kidney failure or end-stage kidney disease.
Metabolic acidosis
Metabolic acidosis is a condition in which there is too much acid in the body fluids.
Read Article Now Book Mark ArticleChronic kidney failure
Chronic kidney disease is the slow loss of kidney function over time. The main job of the kidneys is to remove wastes and excess water from the body...
Read Article Now Book Mark ArticleEnd-stage kidney disease
End-stage kidney disease (ESKD) is the last stage of long-term (chronic) kidney disease. This is when your kidneys can no longer support your body's...
Read Article Now Book Mark ArticleWhen to Contact a Medical Professional
Contact your provider if you have symptoms of interstitial nephritis.
If you have interstitial nephritis, contact your provider if you get new symptoms, especially if you are less alert or have a decrease in urine output.
Prevention
Often, the disorder can't be prevented. Avoiding or reducing your use of medicines that can cause this condition can help reduce your risk. If needed, your provider will tell you which medicines to stop or reduce.
References
Ghossein C, Neilson EG. Interstitial nephritis. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 108.
Perazella MA, Rosner MH. Tubulointerstitial diseases. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner and Rector's The Kidney. 10th ed. Philadelphia, PA: Elsevier; 2020:chap 35.
Tanaka T, Nangaku M. Chronic interstitial nephritis. In: Johnson RJ, Floege J, Tonelli M, eds. Comprehensive Clinical Nephrology. 7th ed. Philadelphia, PA: Elsevier; 2024:chap 65.
Kidney anatomy - illustration
The kidneys are responsible for removing wastes from the body, regulating electrolyte balance and blood pressure, and the stimulation of red blood cell production.
Kidney anatomy
illustration
Review Date: 8/28/2023
Reviewed By: Walead Latif, MD, Nephrologist and Clinical Associate Professor, Rutgers Medical School, Newark, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.