TREATMENT

Initial treatment for acute interstitial nephritis includes discontinuation of all potential offending drugs and eradication of any potential infections. Once an offending drug has been identified it should never be reintroduced because it will reliably cause future episodes of interstitial nephritis.

In addition, there is recent evidence that early steroid administration in drug-induced disease leads to faster and greater recovery of renal function. Thus, in the absence of any contraindications, a limited course of corticosteroids may be considered.

PROGNOSIS

Most patients will experience complete recovery of renal function. A minority will progress to end stage renal disease and require renal replacement therapy. The duration of renal failure, rather than the peak serum creatinine concentration, appears to be the most important indicator of eventual recovery. Some data also suggest patients of advanced age may have a less favorable prognosis.