Acute kidney injury in interstitial nephritis
Abstract
Purpose of review: The purpose of this review is to describe the most common causes of acute interstitial nephritis (AIN), the diagnostic work-up and the therapeutic management. Recent findings: Several case series and registries have found an increasing incidence of AIN, especially among older patients. Drug-induced AIN still represents the most common cause. Early withdrawal of the culprit drug together with corticosteroid therapy remain the mainstay of treatment, although recent studies have shown that prolonged treatment beyond 8 weeks does not further improve kidney function recovery. Summary: AIN is a common cause of acute kidney injury, and therefore, physicians should suspect this entity especially in patients exposed to multiple medications. While immune-allergic reaction to numerous drugs is the most common cause of AIN, other underlying systemic diseases may also be involved, and therefore, every patient should undergo a complete diagnostic evaluation. Kidney biopsy provides the definitive diagnosis of AIN, and certain histologic features may help to identify the underlying condition. In drug-induced AIN, an early discontinuation of the culprit drug is the mainstay of therapy, and unless a rapid recovery of kidney function is observed, a course of glucocorticoid therapy should be initiated.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Direct cytopathic effects of microbial antigens or cytokine-mediated inflammation may explain renal injury in infection-associated AIN.
“the direct cytopathic effects of microbial antigens or cytokine-mediated inflammation may be the explanation for the renal injury [14, 51]”
From The diagnosis of acute interstitial nephritis caused by infection versus antibiotic-induced interstitial nephritis: a narrative review (2024) · cites this paper as [51]
Cites
Regulated cell death and inflammation: an auto-amplification loop causes organ failure
Linkermann, A., Stockwell, B. R., Krautwald, S., & Anders, H.-J. (2014) · Nature Reviews Immunology · doi:10.1038/nri3743 · Cited by 522 · see citing works
González, E., Gutiérrez, E., Galeano, C., Chevia, C., de Sequera, P., Bernis, C., Parra, E. G., Delgado, R., Sanz, M., Ortiz, M., et al. (2008) · Kidney International · doi:10.1038/sj.ki.5002776 · Cited by 466 · see citing works
Self-citationDrug-induced acute interstitial nephritis
Perazella, M. A., & Markowitz, G. S. (2010) · Nature Reviews Nephrology · doi:10.1038/nrneph.2010.71 · Cited by 378 · see citing works
Acute interstitial nephritis: clinical features and response to corticosteroid therapy
Clarkson, M. R. (2004) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfh485 · Cited by 343 · see citing works
Praga, M., Sevillano, A., Auñón, P., & González, E. (2015) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfu326 · Cited by 147 · see citing works
Self-citationFernandez-Juarez, G., Perez, J. V., Caravaca-Fontán, F., Quintana, L., Shabaka, A., Rodriguez, E., Gadola, L., de Lorenzo, A., Cobo, M. A., Oliet, A., et al. (2018) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.01390118 · Cited by 133 · see citing works
Self-citationMechanisms of Drug-Induced Interstitial Nephritis
Raghavan, R., & Shawar, S. (2017) · Advances in Chronic Kidney Disease · doi:10.1053/j.ackd.2016.11.004 · Cited by 117 · see citing works
Clinical Approach to Diagnosing Acute and Chronic Tubulointerstitial Disease
Perazella, M. A. (2017) · Advances in Chronic Kidney Disease · doi:10.1053/j.ackd.2016.08.003 · Cited by 79 · see citing works
Long-term outcome in biopsy-proven acute interstitial nephritis treated with steroids
Prendecki, M., Tanna, A., Salama, A. D., Tam, F. W. K., Cairns, T., Taube, D., Cook, H. T., Ashby, D., Duncan, N. D., & Pusey, C. D. (2016) · Clinical Kidney Journal · doi:10.1093/ckj/sfw116 · Cited by 63 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Muhammad, A., Zhang, Y., Huang, L., Yuan, Q., Wang, W., Pu, J., Lin, W., Tang, R., & Xiao, X. (2024) · Clinical Kidney Journal · doi:10.1093/ckj/sfae054 · Cited by 13 · see citing works
“Furthermore, the direct cytopathic effects of microbial antigens or cytokine-mediated inflammation may be the explanation for the renal injury [14 , 51 ] ( Table 1 [32 –48 ]) .”
Background
- Authors
- Caravaca-Fontán, F., Fernández-Juárez, G., & Praga, M.
- Affiliations
- Department of Nephrology, Instituto de Investigación Hospital Universitario 12 de Octubre (i+12)
- Department of Nephrology, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain
- Universidad Complutense de Madrid (ES)
- Corresponding author
- Praga, Manuel
- ORCID
- Praga, Manuel
- Venue
- Current Opinion in Critical Care
- Published
- 2019-12
- Volume
- 25
- Issue
- 6
- Pages
- 558-564
- ISSN
- 1070-5295 (ISSN-L)
- 1531-7072
- OpenAlex
- W2973003790
- Cited by
- 39
- References
- 9
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 12 · 2023: 10 · 2022: 6 · 2021: 6 · 2020: 2
- FWCI
- 0.55
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Opinion in Critical Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Nephrology › Acute Kidney Injury Research
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Nephrotoxicity and Medicinal Plants
- Health Sciences › Medicine › Nephrology › Renal Diseases and Glomerulopathies
- Keywords
- acute interstitial nephritis, acute kidney injury, drug-induced nephrotoxicity, corticosteroid therapy, drug withdrawal, renal biopsy, renal function recovery
- MeSH terms
- Humans, Nephritis, Interstitial, Acute Kidney Injury
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
