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What is chronic tubulointerstitial nephritis?
Chronic tubulointerstitial nephritis is characterized by the presence of chronic interstitial inflammation, interstitial fibrosis, and tubular atrophy, which leads to chronic kidney disease (CKD).
Causes of chronic tubulointerstitial nephritis are listed below
Causes of Chronic Tubulointerstitial Nephritis
Primary or idiopathic
Epstein-Barr virus
Secondary
Infections
Polyomavirus
Pyelonephritis (acute and chronic)
Drugs
Analgesic abuse nephropathy
Lithium-induced kidney disease
Acyclic nucleoside inhibitors
Calcineurin inhibitors
Aristolochic acid/Chinese herb nephropathy
Chemotherapeutic agents: cisplatin, ifosfamide, carmustine
Heavy metals
Lead nephropathy
Cadmium
Hematologic diseases
Multiple myeloma
Lymphoproliferative disorders
Light chain disease
Sickle cell nephropathy
Obstructive uropathy
Reflux nephropathy
Immune-mediated diseases
Sarcoidosis
Lupus
IgG4-related disease
Primary Sjögren’s syndrome
Tubulointerstitial nephritis with uveitis
Idiopathic hypocomplementemic interstitial nephritis
Metabolic disorders
Hyperoxaluria
Hypercalcemia/hypercalciuria
Hypokalemic nephropathy
Genetic disorders
Cystinosis
Dent disease
Miscellaneous
Endemic (Balkan) nephropathy
Radiation nephritis
Different diseases affect different segments of the tubule. The functional abnormalities depend on the tubular site of involvement. For example, Sjögrens leads to distal tubular injury and is associated with metabolic acidosis (type 1 RTA) and hypokalemia. Injury involving the kidney medulla is characterized by impaired ability to concentrate urine, as seen in sickle cell nephropathy
