Renal tubulo-interstitial disorders
Causes
|
Appropriate Tests
|
|
Diagnosis guided by clinical context.
Biopsy may be required to establish underlying cause.
Baseline studies may include: Electrolytes, Creatinine, Urea, Calcium, Phosphate, Albumin, Full blood count.
Urine - microscopy. Urine acidification test only if significant renal tubular acidosis is suspected.
Water deprivation test if polyuria is clinically significant.
Renal biopsy if indicated.
|
Toxic
|
|
Analgesic nephropathy
|
See Analgesic abuse
|
Other drugs, especially
-
Aminoglycosides
-
Amphotericin B
-
Cyclosporin
-
Lithium
-
Cis-platinum
|
Antibiotic assay (aminoglycoside).
Cyclosporin levels
Lithium |
Lead poisoning
|
|
Metabolic
|
|
Crystal nephropathy, especially
|
Urine - microscopy.
See Gout
Oxalate urine
|
Hypercalcaemia
|
|
Hypokalaemia
|
|
Drug hypersensitivity interstitial nephritis
|
Urine - microscopy (examination for eosinophils). Assay of Immunoglobulin E is of no clinical value.
|
-
NSAID
-
Penicillin
-
Cephalosporins
-
Phenindione
-
Thiazides
-
Frusemide
|
|
Infection
|
|
Pyelonephritis, acute
|
See Urinary tract infection
|
Tuberculosis
|
|
Leptospirosis
|
|
Other
|
|
Transplant rejection
|
|
Sjögren syndrome
|
|
Amyloidosis
|
|
Plasma cell myeloma
|
|
Medullary sponge kidney
|
|