Renal tubulo-interstitial disorders
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Causes
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Appropriate Tests
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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.
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Toxic
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Analgesic nephropathy
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See Analgesic abuse
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Other drugs, especially
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Aminoglycosides
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Amphotericin B
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Cyclosporin
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Lithium
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Cis-platinum
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Antibiotic assay (aminoglycoside).
Cyclosporin levels
Lithium |
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Lead poisoning
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Metabolic
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Crystal nephropathy, especially
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Urine - microscopy.
See Gout
Oxalate urine
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Hypercalcaemia
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Hypokalaemia
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Drug hypersensitivity interstitial nephritis
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Urine - microscopy (examination for eosinophils). Assay of Immunoglobulin E is of no clinical value.
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NSAID
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Penicillin
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Cephalosporins
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Phenindione
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Thiazides
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Frusemide
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Infection
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Pyelonephritis, acute
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See Urinary tract infection
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Tuberculosis
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Leptospirosis
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Other
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Transplant rejection
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Sjögren syndrome
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Amyloidosis
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Plasma cell myeloma
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Medullary sponge kidney
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