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Urinary sediment findings in acute interstitial nephritis.

RESEARCH LETTERS Urinary Sediment Findings in Acute Interstitial Nephritis To the Editor: Acute interstitial nephritis (AIN) is a condition characterized by acute kidney injury associated with acute cellular infiltrate of the renal interstitium due to various causes. Published data for urinary sediment findings in AIN are few. In this case series, we describe detailed findings observed in 21 patients with biopsy-proven AIN due to different causes. We reviewed all reports of biopsies performed on native kidneys at our institution during a 14-year period (January 1, 1997, to February 1, 2011) and identified AIN cases. All patients with AIN were considered for inclusion. All microscopic slides arising from these kidney biopsies were reviewed by 2 of us for the presence or absence of interstitial cellular infiltrate, tubulitis, tubular necrosis, tubular basement membrane gaps, interstitial red blood cell (RBC) extravasation, RBCs, and intratubular RBC casts. Of 839 kidney biopsies, 23 (2.7%) were found to have AIN in the absence of significant glomerular lesions. We included 21 patients (Table 1), having excluded one because of bacteria (2 ) in the urinary sediment and another for focal glomerular immunoglobulin A and C3 by immunofluorescence (which was negative at the glomerular level in all other cases).