44 - Chronic Tubulointerstitial Disease

Abstract

Chronic interstitial nephritis is part of the spectrum of primary interstitial kidney diseases that are associated with interstitial inflammation and accompanying tubular cell damage. Interstitial nephritis has been generally classified morphologically and clinically into acute and chronic forms. Acute interstitial nephritis is characterized by a rapid deterioration in kidney function and an active interstitial inflammatory infiltrate, interstitial edema, and varying degrees of tubular cell damage. In contrast, chronic interstitial nephritis is more slowly progressive and is characterized by interstitial mononuclear cell infiltration, tubulointerstitial fibrosis, and tubular atrophy. There are several causes of chronic interstitial nephritis. They include systemic diseases, autoimmune processes, metabolic disorders, infiltrative diseases, chronic infections, medications, toxin/heavy metal exposure, and progression from acute to chronic interstitial nephritis. In addition, primary glomerular diseases can also cause chronic interstitial disease. Treatment is directed at the underlying causative diseases and general CKD care.