How can you tell the difference between acute tubular necrosis and interstitial nephritis?

For example, acute interstitial nephritis (AIN) requires withdrawal of the offending drug and immunosuppressive therapy, while acute tubular injury (ATI) does not have any disease-specific therapies. Failure to distinguish AIN from ATI in a timely manner can lead to kidney fibrosis and chronic kidney disease.

How can you tell the difference between ATN and AIN?

In general, a scan that is considered positive and indicative of AIN requires at least 2+ intensity in the kidneys. One situation where renal scanning with 67gallium scintigraphy may be useful is in differentiating AIN from ATN when kidney biopsy is contraindicated or refused by the patient.

What are the signs and symptoms of acute tubular necrosis?

Symptoms

  • Decreased consciousness, coma, delirium or confusion, drowsiness, and lethargy.
  • Decreased urine output or no urine output.
  • General swelling, fluid retention.
  • Nausea, vomiting.

How do you rule out interstitial nephritis?

The only way of getting an accurate interstitial nephritis diagnosis is through various laboratory tests: Kidney function tests. These are blood tests that can detect signs of failure in your kidneys. They can detect waste products, metabolic acidosis, acidosis, uric acid, and phosphate.

How do you diagnose acute interstitial nephritis?

Renal biopsy is the gold standard for diagnosis of AIN, with the typical histopathologic findings of plasma cell and lymphocytic infiltrates in the peritubular areas of the interstitium, usually with interstitial edema.

What is allergic interstitial nephritis?

Allergic interstitial nephritis (AIN) is the most common form of acute interstitial nephritis. It is most often caused by exposure to a drug. AIN is often associated with a sharp decline in renal function and may be related to permanent renal insufficiency.

What hallmark finding is typical of acute tubular necrosis?

Acute tubular necrosis causes marked arteriolar vasoconstriction; the degree of vasoconstriction is related to the severity of the ATN. The Doppler hallmark of ATN is therefore reduced diastolic flow, reflected as an elevated resistance index (RI).

What are symptoms of interstitial nephritis?

Symptoms of this condition may include:

  • Blood in the urine.
  • Fever.
  • Increased or decreased urine output.
  • Mental status changes (drowsiness, confusion, coma)
  • Nausea, vomiting.
  • Rash.
  • Swelling of any area of body.
  • Weight gain (from retaining fluid)

Is acute interstitial nephritis an allergic reaction?

The acute form of interstitial nephritis is most often caused by side effects of certain drugs. The following can cause interstitial nephritis: Allergic reaction to a drug (acute interstitial allergic nephritis). Autoimmune disorders, such as anti-tubular basement membrane disease or Kawasaki disease.