What is the role of acute interstitial nephritis in the pathophysiology of azotemia?

Updated: Apr 24, 2020
  • Author: Moro O Salifu, MD, MPH, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Acute interstitial nephritis is characterized by inflammation and edema, which result in azotemia, hematuria, sterile pyuria, white blood cell (WBC) casts with variable eosinophiluria, proteinuria, and hyaline casts. The net effect is a loss of urinary concentrating ability, with low osmolality (< 500 mOsm/L), low specific gravity (< 1.015), high urinary sodium (>40 mEq/L), and, occasionally, hyperkalemia and renal tubular acidosis. However, if there is superimposed prerenal azotemia, the specific gravity, osmolality, and sodium may be misleading.

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