ACUTE-RENAL-FAILURE IN PATIENTS WITH DRUG-INDUCED ACUTE INTERSTITIAL NEPHRITIS

被引：37

作者：

KOSELJ, M

KVEDER, R

BREN, AF

ROTT, T

机构：

[1] Department of Nephrology, University Medical Center, Ljubljana

[2] Institute of Pathology Faculty of Medicine, University of Ljubljana, Ljubljana

来源：

RENAL FAILURE | 1993年 / 15卷 / 01期

关键词：

D O I：

10.3109/08860229309065575

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

The clinical features, laboratory evaluation, and outcome were analyzed in 23 patients with acute renal failure (ARF) and drug-induced acute interstitial nephritis (21 proven with biopsy). The groups of drugs implicated were: antibiotics (20 cases), nonsteroidal anti-inflammatory drugs (2 cases), and other drugs (phenobarbitone, 1 case). The clinical and laboratory signs of the disease appeared 3 to 28 days after exposure to the drug. Fever, skin rash, and flank tenderness were the most common clinical features observed (87%); and hematuria (100%), sterile pyuria (83%), and eosinophilia (39%) were established by laboratory tests. Hemodialysis (HD) was performed in 7 patients. Complete normalization of kidney function function was observed in 3 patients; improvement to basal level in 3 patients (this group had preexisting renal disease); and CRF, requiring HD, in 1 patient. Renal function improved in all patients with mild to moderate renal insufficiency regardless of the therapy involved. Statistical evaluation could not confirm any significant differences between status of renal function at presentation, treatment (corticosteroids versus symptomatic and supportive measures only), and outcome of drug-induced acute interstitial nephritis (AIN). In summary, ARF due to drug-induced AIN has a favorable course with good prognosis regardless of the use or nonuse of corticosteroids in management strategy.

引用

页码：69 / 72

页数：4

共 9 条

[1]

Linton A.L., William M.B., Clark W.F., Driedger A.A., Turnbull D.I., Lindsay R.M., Acute interstitial nephritis due to drugs, Ann Intern Med, 93, pp. 735-741, (1980)

[2]

Revert L., Montoliu J., Acute interstitial nephritis, Semin Nephrol, 8, pp. 82-88, (1988)

[3]

Pusey C.D., Saltissi D., Bloodworth L., Rainford D.J., Christie J.L., Drug associated acute interstitial nephritis: Clinical and pathological features and the response to high dose steroid therapy, Q J Med, 206, pp. 194-211, (1983)

[4]

Cameron J.C., Allergic interstitial nephritis: Clinical features and pathogenesis, Q J Med, 66, pp. 97-115, (1988)

[5]

Galpin J.E., Shinaberger J.H., Stanley T.S., Blumenkrantz M.J., Bayer A.S., Friedman G.S., Montgomerie J.Z., Guze L.B., Coburn J.W., Glassock R.J., Acute interstitial nephritis due to methicillin, Am J Med, 65, pp. 756-765, (1978)

[6]

Toto R.D., Acute tubulointerstitial nephritis, Am J Med Sci, 299, pp. 392-408, (1990)

[7]

Buysen J.G.M., Houthoff H.J., Krediet R.T., Arisz L., Acute interstitial nephritis: A clinical and morphological study in 27 patients, Nephrol Dial Transplant, 5, pp. 94-99, (1990)

[8]

Wilson D.M., Turner D.R., Cameron J.S., Ogg C.S., Brown C.B., Chantler C., Value of renal biopsy in acute intrinsic renal failure, Br Med J, 21, pp. 459-461, (1976)

[9]

Laberke H.G., Drug-associated nephropathy. Part II: Tubulointerstitial lesions. A: Acute interstitial nephritis, nephrotoxic lesions, analgesic nephropathy, Curr Top pathol, 69, pp. 184-215, (1980)

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