genitourinary disorders
Tubulointerstitial Nephritis
Prognosis for Tubulointerstitial Nephritis
In medication-induced ATIN, renal function usually recovers within 6 to 8 weeks when the causative medication is stopped, although some residual scarring is common. Recovery may be incomplete, with persistent azotemia above baseline. Prognosis is usually worse if ATIN is caused by NSAIDs than by other medications. When other factors cause ATIN, histologic changes usually are reversible if the cause is recognized and removed; however, some severe cases progress to fibrosis and Chronic Kidney Disease . Regardless of cause, irreversible injury is suggested by the following: Diffuse rather than patchy interstitial infiltrate Significant interstitial fibrosis Delayed response toprednisone Acute kidney injury lasting>3 weeks In CTIN, prognosis depends on the cause and on the ability to recognize and stop the process before irreversible fibrosis occurs. Many genetic (eg, Overview of Cystic Kidney Disease ), metabolic (eg, cystinosis), and toxic (eg, previous exposure to heavy metals) causes may not be modifiable, in which case CTIN usually evolves to 