Causes of Acute Tubulointerstitial Nephritis
Cause | Examples |
|---|---|
Medications* | |
Antibiotics | Beta-lactam antibiotics (the most common cause) Macrolides |
Antiseizure medications | Valproate |
Diuretics | Thiazides |
Nonsteroidal anti-inflammatory drugs (NSAIDs) | |
Other | Aristolochic acid† Interferon alfa |
Metabolic disorders | |
Hyperoxalaturia | |
Hyperuricosuria | |
Renal parenchymal infection | |
Bacterial | Brucella species (brucellosis) Corynebacterium diphtheriae Legionella species (Legionella infections) Leptospira species (leptospirosis) Mycobacterium species Mycoplasma species Rickettsia species Salmonella species Staphylococci Streptococci Treponema pallidum (syphilis) Yersinia species |
Fungal | Candida species |
Parasitic | Toxoplasma gondii (toxoplasmosis) |
Viral | Hepatitis C virus (acute and chronic) Polyomavirus |
Other conditions | |
Idiopathic without and with uveitis | — |
Immunologic | Anti-tubular basement membrane (anti-TBM) antibody-associated interstitial nephritis Granulomatosis with polyangiitis Idiopathic hypocomplementemic interstitial nephritis IgG4-related tubulointerstitial nephritis‡ Renal transplant rejection Systemic lupus erythematosus (SLE); rare |
Neoplastic | |
* Most common causative medications are listed; > 120 medications are implicated. | |
† Contained in some medicinal herbs used in traditional Chinese medicine. | |
‡ Yamaguchi Y, Kanetsuna Y, Honda K, et al: Characteristic tubulointerstitial nephritis in IgG4-related disease. Hum Pathol 43(4):536-549, 2012. doi: 10.1016/j.humpath.2011.06.002 | |