Clinical Manifestations of Acute Interstitial Nephritis

Acute interstitial nephritis due to its etiology, clinical manifestation, no
specificity.Main outstanding performance for oliguria or non oliguria acute renal insufficiency, can may be accompanied by fatigue, fever and nonspecific manifestation such as joint pain.Renal tubular function loss can appear low density and low osmotic pressure and urine, and tubular proteinuria water, electrolyte and acid-base balance disorders, some patients presented with Fanconi syndrome.

Drug related acute interstitial nephritis often relatively typical course: in the use of pathogenic drugs appeared a few days or weeks after the kidney damage, urine can decrease or no change, abnormal urine test, with gross hematuria, aseptic leukocyte urine, flank pain, there is no high blood pressure and edema, often accompanied by whole body allergic symptoms such as fever, rash, acidophil increase views, most patients with gastrointestinal symptoms, including nausea, vomiting.Of acute interstitial nephritis caused different drugs have different clinical manifestations.Some patients even if the original for a certain drug resistance, use the drug again exposed acute interstitial nephritis.Non-steroidal anti-inflammatory drugs (nsaids) caused by acute interstitial nephritis can appear a lot of proteinuria.

Infections associated with acute interstitial nephritis patients had more than a sign of infection, such as fever, chills, headache, nausea, vomiting, and even sepsis, and even may be accompanied by other symptoms of organ systems, such as pneumonia, myocarditis, liver damage, etc.The acute pyelonephritis concurrent infection is the most common of renal parenchyma.Most of the renal parenchyma infection secondary to the urethra and bladder infections, its clinical manifestations varied, from mild discomfort to sepsis symptoms can appear: more rapid onset, often have chills, fever, rib ridge Angle tenderness, urinary irritation symptoms such as performance.Atypical cases show is weak, low back pain, weight loss, recurrent cystitis (dysuria, urinary frequency, urgency, pubic arch pain), etc.About a third of the elderly patients can have no fever, 20% of the elderly patients with digestive tract symptoms or pulmonary symptoms as the main performance.Urine checks visible white blood cells, urine, pyuria and bacteriuria positive urine culture.

For men, prostatitis and prostatic hypertrophy caused by urinary tract obstruction is an important reason.Blood-borne infections caused by acute interstitial nephritis occurs in the elderly, people with diabetes patients and long-term use of immunosuppressive or NSAIDs.

Idiopathic acute interstitial nephritis among young women, clinical manifestations of eye fatigue, fever, rash, muscle pain, uveitis, some patients with lymph node enlargement, urine in mild to moderate proteinuria, renal tubular injury, non oliguria renal insufficiency.About a third of the patients can merge ocular symptoms, ocular symptoms can appear in kidney disease a few weeks before, at the same time or after a few months.80% mainly confined to the former pigment membrane, but also a coloring film after involvement.Clinical but no symptoms, but also can appear eye pain, photophobia, tears, visual impairment, etc.Physical examination can be found that the ciliary hyperemia or mixed with blood, aqueous humor turbidity, sediment and iris adhesion after corneal.20% of the patients can appear after the iris adhesion, complications such as intraocular pressure change.Laboratory tests can have anemia, quick acidophil increase, blood sedimentation, elevated CRP and globulin.The type of hormone treatment effect is obvious.


Other clinical manifestations of acute interstitial nephritis caused by systemic disease can appear at the same time the system of the specific clinical manifestation of disease, such as systemic lupus erythematosus (sle) patients can have facial erythema, joint pain, frequent light allergic, hair loss, oral ulcer, sjogren's syndrome can appear dry mouth, dry eye, multiple cavities, etc.