Chronic Tubulointerstitial Nephropathy
last authored:
last reviewed:
Introduction
Chronic Tubulointerstitial Nephropathy is characterized by by slowly progressive renal insufficiency, proteinuria <3.5g/day, and tubular damage disproportionately severe than degree of kidney impairment.
The Case of...
a simple case introducing clincial presentation and calling for a differential diagnosis to get students thinking.
Causes and Risk Factors
Certain causes tend to damage only a certain segment of the nephron and.
Chronic urinary obstruction, drug-induced nephropathy (analgesics, cytotoxic, or immunosuppressive agents), multiple myeloma, heavy metal toxicity (lead, cadmium), sickle cell disease, immune disorders (SLE, transplant rejection, Sjogren's syndrome) or polycystic kidney disease can lead to chronic tubulointerstitial nephropathy.
Pathophysiology
Chronic tubulointerstitial nephropathy is characterized by interstitial mononuclear cell infoltrate and fibrosis, along with atrophy and loss of renal tubules.
Signs and Symptoms
- history
- physical exam
History
Most patients have little or no clinical evidence of inflammation,
Physical Exam
Investigations
- lab investigations
- diagnostic imaging
Lab Investigations
Urinalysis can show pyuria and minimal hematuria, with occasional leukocyte and granular casts.
Proteinuria is usually less than 1 g/day.
Modest sodium wasting, hyperkalemia, and normal anion gap acidosis are common.
Diagnostic Imaging
Differential Diagnosis
Treatments
Consequences and Course
Chronic interstitial nephropathy is an important cause of chronic renal failure and appears to be responsible for 15-30% of all cases of end stage renal disease.
Resources and References
Topic Development
authors:
reviewers:
 |