Acute Interstitial Nephritis
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First Things First (assess & treat for the following)
Suspect AIN if:
- There is an acute rise in the plasma creatinine concentration temporally related to an offending drug or infection.
- Triad of fever, rash and eosinophilia may be present (except in NSAID-induced AIN).
- Urine sediment that usually reveals white cells, red cells, white cell casts
- Eosinophilia & eosinophiluria in >75% of cases, w/ the exception of disease induced by NSAIDs
- Normal or only mildly increased protein excretion (< 1 g/day). Concurrent nephritic syndrome due to minimal change disease is often seen w/ NSAIDs & in selected cases induced by ampicillin, rifampin, interferon or ranitidine.
- Signs of tubulointerstitial damage such as Fanconi syndrome & renal tubular acidosis