ISSN: 1305-385X
Hakkında: Özel sayılar şeklinde yayınlanır.
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Chronic Tubulointerstitial Nephritis
Dr. Hayriye SAYARLIOĞLU,a Dr. Reha ERKOÇ,b Dr. Yasemin SOYORALb
aNefroloji BD, Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi, KAHRAMANMARAŞbNefroloji BD, Yüzüncü Yıl Üniversitesi Tıp Fakültesi, VAN
Tubulointerstitial nephritis is primary injury to renal tubules and interstitium resulting in decreased renal function. The acute form is most often due to allergic drug reactions or to infections. The chronic form is associated with a diverse array of diseases, including genetic, metabolic obstructive uropathy, and chronic environmental toxins, or to certain drugs and herbs. The most common form of tubulointerstitial inflammation is immunologic. Important causes include analgesics; lead; drugs, including cyclosporine, cisplatin, and lithium; and metabolic disorders, notably hypercalcemia, potassium depletion, and hyperoxaluria. Because of its insidious nature, chronic tubulointerstitial nephritis is often diagnosed incidentally on routine laboratory screening or evaluation of hypertension. Patients are usually asymptomatic. Hypertension is common but not universal. Clinical investigations may show modest elevation in serum creatinine, evidence of tubular dysfunction (ie, renal tubular acidosis), or Fanconi syndrome (ie, aminoaciduria, glycosuria, hypophosphatemia, hypouricemia). Proteinuria is usually mild, often less than 1 g/d. In diseases predominantly involving tubular structures, decreased endocytosis of filtered proteins leads to the characteristic tubular proteinuria. Diagnosis is suggested by history and urine and blood tests and confirmed by biopsy. Treatment and prognosis vary by the etiology and underlying disorders.Keywords: Nephritis; nephritis, interstitialTurkiye Klinikleri J Int Med Sci 2007, 3(21):12-26
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