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'''For patient information, click [[Interstitial nephritis (patient information)|here]]'''
'''For patient information, click [[Interstitial nephritis (patient information)|here]]'''
{{Interstitial nephritis}}
{{Interstitial nephritis}}
{{CMG}} {{AE}}{{M.B}}


'''''Synonyms and keywords:''''' Tubulo-interstitial nephritis
{{CMG}} {{AE}}{{M.B}}{{MMJ}}
 
'''''Synonyms and keywords:''''' Tubulointerstitial Nephritis
==[[Interstitial nephritis overview|Overview]]==
==[[Interstitial nephritis overview|Overview]]==
Two main diseases involve the renal tubules are:  Acute tubular necrosis due to Ischemic or toxic injury for more about ATN click [[Acute tubular necrosis|here]]; and tubulointerstitial nephritis with Inflammatory involvement of tubules and interstitium and its consequent  reactions.
Since some  cases of TIN are due  to bacterial infection, and the renal pelvis is deeply involved, therefore [[pyelonephritis]] is term describes this condition; and In general ,the term interstitial nephritis is used for TIN that are owing to  nonbacterial causes of tubular injury such as  drugs, viral infections,autoimmune systemic diseases  in which these condition mechanism of damage is due to inflammatory responses not direct damage.
==[[Interstitial nephritis historical perspective|Historical Perspective]]==
==[[Interstitial nephritis historical perspective|Historical Perspective]]==
* In 1938, Councilman was the first to discover the association between systemic infections and the development of TIN; in autopsy kidneys of children dying of diphtheria and scarlet fever.
* He described the findings as: cellular and fluid exudation in the interstitial tissue of kidneys, before the era of antibiotics.
* The widespread introduction of percutaneous renal biopsy led to the discovery of similar findings in association with drug-related renal failure.Histological examination in ATIN reveals an infiltrate, which is largely composed of T cells, together with some macrophages and plasma cells.
==[[Interstitial nephritis classification|Classification]]==
==[[Interstitial nephritis classification|Classification]]==
There is no established system for the classification of TIN, however according to clinical manifestations and the  inflammatory process, TIN, in spite of the etiologic agent, can be divided into acute and chronic categories.


==[[Interstitial nephritis pathophysiology|Pathophysiology]]==
==[[Interstitial nephritis pathophysiology|Pathophysiology]]==
It is thought that acute interstitial nephritis is mediated by [[hypersensitivity reaction]] to endogenous or exogenous [[antigens]]<nowiki/>expressed by [[Nephron|tubular cells]]. Numerous drugs such as [[antibiotics]], NSAIDS, [[Sulfa-containing antibiotics|sulfa-containing]] drugs, etc, as well as systemic diseases, and Infections may lead injury to renal cells. the cascade activation owing to cellular injury toward inflammatory cell infiltration, and activation of cytokines causes an immunologic reaction in acute or chronic process.
In acute interstitial nephritis, this cascade activation can cause renal tubular dysfunction, whereas in chronic interstitial nephritis an insidious interstitial [[fibrosis]],[[scarring]], , and tubular atrophy spreads gradually and causes progressive [[chronic renal insufficiency]].
==[[Interstitial nephritis causes|Causes]]==
==[[Interstitial nephritis causes|Causes]]==
Common causes of interstitial nephritis include drug side effects, particularly [[analgesics]] and [[antibiotics]]. Other common causes include associated nephrologic conditions, as well as [[microbial]] infections.


==[[Interstitial nephritis differential diagnosis|Differentiating Interstitial nephritis from other Diseases]]==
==[[Interstitial nephritis differential diagnosis|Differentiating Interstitial nephritis from other Diseases]]==


==[[Interstitial nephritis epidemiology and demographics|Epidemiology and Demographics]]==
==[[Interstitial nephritis epidemiology and demographics|Epidemiology and Demographics]]==
==[[Interstitial nephritis risk factors|Risk Factors]]==
==[[Interstitial nephritis risk factors|Risk Factors]]==


==[[Interstitial nephritis natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
==[[Interstitial nephritis natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
==Diagnosis==
==Diagnosis==
[[Interstitial nephritis history and symptoms|History and Symptoms]] | [[Interstitial nephritis physical examination|Physical Examination]] | [[Interstitial nephritis laboratory findings|Laboratory Findings]] | [[Interstitial nephritis KUB x ray|KUB X Ray]] | [[Interstitial nephritis CT|CT]] | [[Interstitial nephritis MRI|MRI]] | [[Interstitial nephritis biopsy and ultrasound|Biopsy and Ultrasound]] | [[Interstitial nephritis other imaging findings|Other Imaging Findings]] | [[Interstitial nephritis other diagnostic studies|Other Diagnostic Studies]]
[[Interstitial nephritis history and symptoms|History and Symptoms]] | [[Interstitial nephritis physical examination|Physical Examination]] | [[Interstitial nephritis laboratory findings|Laboratory Findings]] | [[Interstitial nephritis KUB x ray|KUB X Ray]] | [[Interstitial nephritis CT|CT]] | [[Interstitial nephritis MRI|MRI]] | [[Interstitial nephritis biopsy and ultrasound|Biopsy and Ultrasound]] | [[Interstitial nephritis other imaging findings|Other Imaging Findings]] | [[Interstitial nephritis other diagnostic studies|Other Diagnostic Studies]]

Latest revision as of 01:33, 18 September 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohsen Basiri M.D.Mohamadmostafa Jahansouz M.D.[2]

Synonyms and keywords: Tubulointerstitial Nephritis

Overview

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Pathophysiology

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Differentiating Interstitial nephritis from other Diseases

Epidemiology and Demographics

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