Acute Interstitial Nephritis Flashcards
(14 cards)
How does acute interstitial nephritis present?
rash, fever and eosinophilia
-> elderly patients are more commonly affected, flank pain, oliguria
How does acute interstitial nephritis present?
rash, fever and eosinophilia
-> elderly patients are more commonly affected, flank pain, oliguria
What are the bedside investigations for acute interstitial nephritis?
Urine microscopy shows pyuria and white cell casts; proteinuria may be present but is usually mild
Urine culture is negative (i.e. sterile pyuria)
Blood gas to assess for acidosis and hyperkalaemia that may complicate AKI
ECG looking for hyperkalaemic changes
What is screened in the blood test?
*Full blood count may show eosinophilia (not present in all cases)
*U&Es to confirm renal impairment and assess electrolytes
*Autoimmune screen if an underlying autoimmune cause of AIN is suspected
*Antinuclear antibody (ANA)
*Anti-neutrophil cytoplasmic antibody (ANCA)
*Anti-double stranded DNA
*Complement
What is the imaging for the acute interstitial nephritis?
-> Renal ultrasound
-> Kidneys are usually large
What is the management of acute interstitial nephritis?
Steroids
Short course of oral prednisolone
Diuretics
What is spironolactone?
An aldosterone antagonist which acts in the cortical collecting duct
What is a common indication for spironolactone in patients with cirrhosis?
Ascites due to secondary hyperaldosteronism
What are the typical dosages of spironolactone used for ascites?
100 or 200mg
In which treatment step is spironolactone used for hypertension according to NICE?
Step 4
What condition does spironolactone treat that is supported by the RALES study?
Heart failure
Name a syndrome that spironolactone is indicated for.
Conn’s syndrome
What is a common adverse effect of spironolactone?
Hyperkalaemia
What adverse effect is less common with eplerenone compared to spironolactone?
Gynaecomastia
