^

Health

A
A
A

What causes interstitial nephritis?

 
, medical expert
Last reviewed: 19.10.2021
 
Fact-checked
х

All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.

We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.

If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.

The reasons for the development of tubulointerstitial nephritis are diverse. Acute tubulointerstitial nephritis can develop with various infections, as a result of the use of certain drugs, poisoning, burns, trauma, acute hemolysis, acute circulatory disorders (shock, collapse), as a complication of vaccination, etc.

Chronic tubulointerstitial nephritis also represents a heterogeneous polyethological group of diseases in which, in addition to the above factors, hereditary predisposition and renal dysembryogenesis, metabolic disorders, chronic infection and intoxication, immunologic diseases, adverse environmental factors (heavy metal salts, radionuclides ), etc. Chronic tubulointerstitial nephritis can develop as a continuation of acute.

For the first time, tubulointerstitial nephritis was described by WTCouncilman in 1898 after examining 42 cases of acute nephritis after suffering from scarlet fever and diphtheria. Later, other bacterial, viral and parasitic agents were identified, leading to the development of tubulointerstitial nephritis. Among bacteria, in addition to streptococcus and diphtheria bacillus, they may be pneumococcus, meningococcus, chlamydia, syphilis, typhoid, etc. These bacterial agents cause damage to the renal interstitium by toxic effects, while leptospira and mycobacterium tuberculosis can directly invade the kidney tissue. Among the viruses, the causative agent of mononucleosis, hepatitis viruses, measles virus, etc., as well as herpes viruses persistent in the renal tissue, Coxsackie, Epstein-Barra, AIDS, cytomegalovirus, etc., may have a toxic effect on tubulointerstitium. The possibility of forming tubulointerstitial nephritis as a result of prolonged persistence respiratory viruses - influenza viruses, parainfluenza, adenoviruses, which lead to activation of the persistent urinary system of endogenous coxsackievirus infection. According to various authors, postviral tubulointerstitial nephritis is up to 50% in the structure of all interstitial nephritis.

Among parasites to the emergence of tubulointerstitial nephritis can lead to toxoplasma, mycoplasma, the causative agent of leishmaniasis.

Particular importance in the development of tubulointerstitial nephritis is given to medicinal preparations, especially (beta-lactam antibiotics, sulfonamides, nonsteroidal anti-inflammatory drugs, diuretics, not so much the dose as the duration of the drug intake and individual sensitivity to it.The high risk of tubulointerstitial nephritis originates after 10 days of taking the drug.

Toxic effects on tubulointerstitutions can be provided by various chemical agents, especially heavy metal salts (cadmium, lead chromium, mercury, gold, silver, arsenic, strontium).

Among endogenous factors, a special role in the development of tubulointerstitial nephritis is played by dysmetabolic nephropathies and instability of cytopoietes; vesicoureteral reflux, polycystosis and other developmental anomalies, accompanied by a violation of tubular differentiation and tubular dysfunction. The development of tubulointerstitial nephritis is possible against the background of congenital disorders of hemodynamics and urodynamics, accompanied by circulatory hypoxia, impaired lymph flow.

Medications that can cause tubulointerstitial nephria

Beta-lactam antibiotics

Other antibiotics and antiviral drugs

Anti-inflammatory drugs

Diuretic drugs

Other medicines

Methicillin

Penicillin

Ampicillin

Oxacillin

Nafcillin

Carbenicillin

Amoxicillin

Cephalothin

Cephalexin

Cefradine

Cefotaxime

Cefoxytin

Cefotetan

Sulfonamides

Co-trimoxazole

Rifampicin

Polymyxin

Ethambutol

Tetracycline

Vancomycin

Erythromycin

Kanamycin

Gentamicin

Colistin

Interferon

Acyclovir

Ciprofloxacin

Indomethacin

Phenylbutazone

Fenoprofen

Naproxen

Ibuprofen

Fenazone

Metafenamic acid

Tolmetin

Diflunizal

Aspirin

Fenacetin

Paracetamol

Thiazides

Furosemide

Chlorthalidone

Triamterene

Fenindion

Glafenin

Diphenyl-hydantoin

Cimetidine

Sulfinpyrazone

Allopurinol

Carbamazepine

Clofibrate

Azathioprine

Phenyl-propanolamine

Aldomet

Phenobarbital

Diazepam

D-Penicillamine

Antipyrine

Carbimazole

Cyclosporin

Captopril

Lithium

 
 

Some of the most common nephrotoxic agents

Heavy metals

Inorganic mercury (chloride), organomercury compounds (methyl-, ethyl-, phenylmercury, ethyl mercuricothiosalicylate sodium, mercury diuretics), inorganic lead, organic lead (tetraethyl lead), cadmium, uranium, gold (especially sodium arothiomalate), copper, arsenic, arsine arsenious hydrogen), iron, chromium (especially trioxide), thallium, selenium, vanadium, bismuth

Solvents

Methanol, amyl alcohol, ethylene glycol, diethylene glycol, cellosol, carbon tetrachloride, trichlorethylene, various hydrocarbons

Substances that cause oxalosis

Oxalic acid, methoxyflurane, ethylene glycol, ascorbic acid, anticorrosive substances

Antineoplastic agents

Cyclosporine, cisplatin, cyclophosphamide, streptozocin, methotrexate, nitrosoureas derivatives (CCNU, BCNU, methyl-CCNU), doxorubicin, daunorubicin

Diagnostic Agents

Sodium iodide, all organic iodide contrast agents

Herbicides and pesticides

Paraquat, cyanides, dioxin, cyphenyl, cyclohexamides and organochlorine
insecticides: endrin, aldrin, endosulfan, dieldrin, lindane, hexachlorobenzene,
dichlorodiphenyltrichloroethane (DDT), heptachlor, chlordecone, polychlorine derivatives of
terpene, chlordane, dicofol (keltan), chlorobenzylate, mirex, methoxychloro

Biological factors

Mushrooms (for example, Amanito phalloides causes severe muscarinic poisoning), poisons of snakes and spiders, insect bites, aflatoxins

Inductors of immune complexes

Penicillamine, captopril, levamisole, gold salts

An important role in the development of tubulointerstitial nephritis is also played by allergic reactions and immunodeficiency states.

You are reporting a typo in the following text:
Simply click the "Send typo report" button to complete the report. You can also include a comment.