{"id":8105,"date":"2021-11-15T22:59:47","date_gmt":"2021-11-15T20:59:47","guid":{"rendered":"https:\/\/meddists.com\/learn\/clinical\/nephrology\/chronic-interstitial-nephritis-analgesics-and-nsaids-nephropathies\/"},"modified":"2022-01-15T01:19:45","modified_gmt":"2022-01-14T23:19:45","slug":"chronic-interstitial-nephritis-analgesics-and-nsaids-nephropathies","status":"publish","type":"page","link":"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/nephrology\/chronic-interstitial-nephritis-analgesics-and-nsaids-nephropathies\/","title":{"rendered":"Chronic interstitial nephritis, analgesics and NSAIDs nephropathies"},"content":{"rendered":"\n

Chronic interstitial nephritis<\/h3>\n<\/span>\n\n\n

Chronic interstitial nephritis is a type of tubulointerstitial nephritis; there are acute <\/strong>and chronic <\/strong>interstitial nephritis.<\/p>\n\n\n\n

The term interstitial nephritis generally means non-infectious TIN.<\/p>\n\n\n\n

CIN is characterized by chronic inflammation<\/strong> and insult of the renal interstitium<\/strong> (the tissue surrounding the glomeruli and tubules) lasting years, leading to scarring <\/strong>of the interstitium, reduction of kidney function up to ESRD, and in many cases, glomerulosclerosis.<\/p>\n\n\n\n

Compared with AIN, there’s no pyuria.<\/p>\n\n\n<\/span>\n

Etiology<\/h4>\n<\/span>\n\n\n

There are a variety of causes for CIN:<\/p>\n\n\n\n

  • Drugs (NSAID, analgesics)<\/li>
  • Autoimmune (Sjorgen’s, SLE)<\/li>
  • Metabolic (hyperuricemia, hypercalcemia)<\/li>
  • Heavy-metal<\/li>
  • Reflux disease<\/li>
  • Neoplasm (MM, leukemia, lymphoma)<\/li>
  • Hereditary diseases (PKD)<\/li><\/ul>\n\n\n<\/span>\n

    Symptoms<\/h4>\n<\/span>\n\n\n
    • Symptoms and signs are generally absent in chronic tubulointerstitial nephritis unless renal failure develops. <\/li>
    • Edema usually is not present, and blood pressure is normal or only mildly elevated in the early stages.<\/li>
    • Polyuria and nocturia may develop.<\/li><\/ul>\n\n\n<\/span>\n

      Diagnosis<\/h4>\n<\/span>\n\n\n
      • Increased BUN<\/strong> and Cr <\/strong>levels<\/li>
      • Urinalysis<\/strong>: Eosinophils (non-specific), mild proteinuria, and hematuria<\/li>
      • US and CT<\/strong>: atrophic and hyperechoic kidneys (fibrosis)<\/li>
      • Biopsy<\/strong>: rarely taken<\/li><\/ul>\n\n\n<\/span>\n

        Treatment<\/h4>\n<\/span>\n\n\n
        • Remove offending agent,<\/strong> treat the infection. Recovery takes 6-8 weeks<\/li>
        • Corticoids<\/strong><\/li><\/ul>\n\n\n<\/span>\n

          Analgesic and NSAID nephropathy<\/h3>\n<\/span>\n\n\n

          Analgesic and NSAID nephropathy is a kidney disease caused by a chronic usage of certain analgesics (lifetime usage of over several hundred grams to kgs of certain analgesics).<\/p>\n\n\n\n

          Characterized by non-nephrotic proteinuria, papillary necrosis, and renal failure (HTN, anemia, azotemia).<\/p>\n\n\n\n

          The mechanism is largely unknown, but it is thought to arise by the inhibition of vasodilatory prostaglandins leading to medullary hypoxia and ischemia -> papillary necrosis -> tubular atrophy and fibrosis (CIN).<\/p>\n\n\n\n

          Treatment is avoiding the medication.<\/p>\n<\/span>

          Chronic interstitial nephritis<\/h3>

          Etiology<\/h4>

          Symptoms<\/h4>

          Diagnosis<\/h4>

          Treatment<\/h4>

          Analgesic and NSAID nephropathy<\/h3><\/div>","protected":false},"excerpt":{"rendered":"

          Chronic interstitial nephritis Chronic interstitial nephritis is a type of tubulointerstitial nephritis; there are acute and chronic interstitial nephritis. The term interstitial nephritis generally means non-infectious TIN. CIN is characterized by chronic inflammation and insult of the renal interstitium (the tissue surrounding the glomeruli and tubules) lasting years, leading to scarring of the interstitium, reduction […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":685,"menu_order":9,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-8105","page","type-page","status-publish","hentry"],"yoast_head":"\nChronic interstitial nephritis, analgesics and NSAIDs nephropathies – Meddists<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/meddists.com\/learn\/clinical\/internal-medicine\/nephrology\/chronic-interstitial-nephritis-analgesics-and-nsaids-nephropathies\/\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"2 minutes\" \/>\n<script 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