Hopp til hovedinnhold

Akutt interstitiell nefritt (AIN)

Sist revidert:
Sist revidert av:
Definisjon:
En akutt, oftest reversibel nyresykdom karakterisert av inflammatoriske infiltrater i nyrenes interstitium forårsaket av medikament, infeksjon eller systemisk immunskdom
Forekomst:
Forholdsvis sjelden tilstand
Symptomer:
Uspesifikke symptomer på akutt/subakutt nyresvikt som slapphet, nedsatt matlyst, kvalme og brekninger, ev. endret vannlatning/urin
Funn:
Ingen spesifikke kliniske funn, men protein og ofte blod i urin. Fallende nyrefunksjon
Diagnostikk:
Tilleggsundersøkelser er urinprøve, blodprøver, ev. ultralyd. Nyrebiopsi er gullstandard for å bekrefte diagnosen
Behandling:
Behandlingen er først seponering av ev. utløsende medikament, ev. kortikosteroid. 
  1. Perazella MA, Moledina DG. Acute interstitial nephritis. BestPractice, last updated Jan 09, 2020.
  2. Thorp ML. Hypersensitivity nephropathy. Medscape, last updated Dec 01, 2015. emedicine.medscape.com  
  3. Raghavan R, Eknoyan G. Acute interstitial nephritis - a reappraisal and update. Clin Nephrol. 2014 Sep;82(3):149-62. PMID: 25079860 PubMed  
  4. Praga M, Appel GB. Clinical manifestations and diagnosis of acute interstitial nephritis. UpToDate, last updated Mar 30, 2015. UpToDate  
  5. Praga M, González E. Acute interstitial nephritis. Kidney Int 2010; 77:956. PubMed  
  6. Høieggen A, Os I. Nyreskade forårsaket av legemidler. Tidsskr Nor Legeforen 2012; 132: 1462-4. doi:10.4045/tidsskr.11.0773 DOI  
  7. Nast CC. Medication-induced interstitial nephritis in the 21st century. Adv Chronic Kidney Dis. 2017 Mar;24(2):72-9. PMID: 28284382 PubMed  
  8. Farid S, Mahmood M, Saleh OMA, et al. Clinical Manifestations and Outcomes of Fluoroquinolone-Related Acute Interstitial Nephritis. Mayo Clin Proc 2018; 93: 25-31. pmid:29157532 PubMed  
  9. Antoniou T, Macdonald EM, Hollands S, et al. Proton pump inhibitors and the risk of acute kidney injury in older patients: a population-based cohort study. CMAJ Open. 2015 Apr-Jun;3(2):E166-71. PMID: 26389094 PubMed  
  10. Al-Aly Z, Maddukuri G, Xie Y. Proton Pump Inhibitors and the Kidney: Implications of Current Evidence for Clinical Practice and When and How to Deprescribe. Am J Kidney Dis 2020; 75: 497-507. pmid:31606235 PubMed  
  11. Burkhart R, Shah N, Lewin M. Sildenafil induced acute interstitial nephritis. Case Rep Nephrol. 2015:731284. PMID: 26491581. PubMed  
  12. Praga M, Sevillano A, Auñón P, González E. Changes in the aetiology, clinical presentation and management of acute interstitial nephritis, an increasingly common cause of acute kidney injury. Nephrol Dial Transplant. 2015 Sep. 30 (9):1472-9. PMID: 25324356 PubMed  
  13. Moledina DG, Wilson FP, Pober JS, et al. Urine TNF-alpha and IL-9 for clinical diagnosis of acute interstitial nephritis. JCI Insight. 2019 May 16;4(10):127456. PMID: 31092735 PubMed  
  14. Moledina DG, Luciano RL, Kukova L, et al. Kidney biopsy-related complications in hospitalized patients with acute kidney disease. Clin J Am Soc Nephrol. 2018 Nov 7;13(11):1633-40. PMID: 30348813 PubMed  
  15. Gonzalez E, Gutierrez E, Galeano C, et al. Early steroid treatment improves the recovery of renal function in patients with drug-induced acute interstitial nephritis. Kidney Int. 2008; 73: 940-6. PubMed  
  16. Appel GB. The treatment of acute interstitial nephritis: more data at last. Kidney Int 2008;73:905-907. PubMed  
  17. Moledina DG, Perazella MA. Drug-induced acute interstitial nephritis. Clin J Am Soc Nephrol. 2017 Dec 7;12(12):2046-9. PMID: 28893923 PubMed  
  18. Pusey CD, Saltissi D, Bloodworth L, Rainford DJ, Christie JL. Drug associated acute interstitial nephritis: clinical and pathological features and the response to high dose steroid therapy. Q J Med 1983;52:194-211. PubMed  
  • Terje Johannessen, professor i allmennmedisin, Trondheim (tilpasning til NEL)
  • Nils Grefberg, med dr och överläkare internmedicin och nefrologi, tidigare vid Medicinkliniken, Centrallasarettet Växjö (Medibas)

Tidligere fagmedarbeidere

  • Knut Aasarød, dr. med., overlege, Nyreavdelingen, St. Olavs Hospital, Trondheim