Acute interstitial nephritis is also called AIN. AIN is a condition in which there is damage to the tissue around the filtering unit of the kidney. This can result in a sudden decline in the kidney function.
In AIN, different types of white blood cells invade the filtering system of the kidney. This causes it to swell. The rise in white blood cells is most often a result of an allergic reaction to a medicine. But it may also be caused by some infections. Most people who have AIN recover completely. But sometimes, scarring results. If that happens, the kidney may have irreversible damage.
AIN may be caused by:
Sometimes the cause is unknown.
Symptoms of AIN include:
The doctor can usually diagnose AIN by doing the following:
Urine and blood tests are done to assess the kidney function. They can also help confirm the diagnosis. Sometimes a skin biopsy of the rash and a kidney biopsy are needed.
Prevention of AIN is not always possible. It helps to avoid contact with the offending medicine in the case of allergic reaction. Other prevention depends on the underlying cause of infection, such as avoiding exposure to strep.
Most cases of kidney damage can be reversed with treatment. But a few cases of AIN may lead to lasting kidney failure.
AIN is not catching and cannot be spread to others. Certain underlying conditions, such as mononucleosis, may be catching.
Treatment will depend on what has caused the disease. If the AIN was caused by an allergic reaction to a medicine, the kidney function usually returns to normal once the medicine is stopped.
If the kidney function does not return or if the damage is severe, steroids may be used. They can help decrease the allergic response. Sometimes short-term dialysis may be needed. This can help remove toxins until the kidney function returns. If the damage to the kidneys can't be reversed, the person may need long-term dialysis. Or, in some cases, a kidney transplant may be needed.
Side effects of steroids may include:
Side effects of surgery may include:
Usually the kidney heals completely and the AIN symptoms slowly go away. If surgery is needed, recovery will depend on the extent of surgery.
The doctor will generally advise regular visits and kidney function tests. Any new or worsening symptoms should be reported to the doctor.
Author:Rajnish K. Dhingra, MD
Date Written:
Editor:Crist, Gayle P., MS, BA
Edit Date:04/25/02
Reviewer:Eileen McLaughlin, RN, BSN
Date Reviewed:07/12/01
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Harrison's Principles of Internal Medicine, Fauci, et al., 2000