How is acute interstitial nephritis managed in intrarenal azotemia?

Updated: Sep 19, 2018
  • Author: Moro O Salifu, MD, MPH, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Acute interstitial nephritis is managed by withdrawing the offending nephrotoxin, avoiding further nephrotoxic exposure, and dehydration. The creatinine level begins to improve within 3-5 days. Renal biopsy may be indicated if renal failure is severe or azotemia is not improving.

Once the diagnosis is confirmed, a trial of oral prednisone (starting at 1 mg/kg/day and tapering over 6 weeks) or IV pulse methylprednisolone (1 g for 3 days) in severe cases may be considered. If the patient is a poor candidate for biopsy but the diagnosis is strongly suspected, therapy should be started.


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