PRESENTATION AND DIAGNOSIS Acute interstitial nephritis typically manifests as AKI following the recent introduction of a new medication. Eighty percent of patients develop symptoms within 3 weeks of drug introduction,…
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…
TREATMENT AND PROGNOSIS HN cannot be targeted with any specific medical treatment. Control of hypertension and proteinuria through renin-angiotensin blockade may slow the progression of glomerulosclerosis and renal insufficiency. The…
ANTI-GBM DISEASE Anti-GBM disease occurs when autoantibodies directly target the glomerular basement membrane, causing inflammation that almost always leads to RPGN. Because anti-GBM disease (either isolated or as part of…
Not all cases of TBMN can be linked to mutations in COL4A3 and COL4A4. Research to better understand the spectrum of mutations that cause TBMN is ongoing. Extrarenal manifestations in…
PROGNOSIS Outcomes in idiopathic disease are poor. More than 60% of patients with type I MPGN will progress to ESRD within 10 years of diagnosis. For DDD, the picture is…
On immunofluorescence, types I and III MPGN usually show prominent granular capillary wall staining with C3, variable amounts of IgG and IgM, and sometimes C1q and C4. In contrast, in…
The pathogenesis of type III MPGN appears similar to that of type I MPGN. Indeed, many consider type III MPGN to be a morphologic variant of type I, although the…
Several different histologic findings may be present in PIGN, and the diagnosis can usually be made using light microscopy and immunofluorescence. On light microscopy, PIGN classically causes diffuse hypercellularity involving…
In adults, the prognosis is much worse, likely in large part due to the underlying comorbidities and chronic infections that predispose to PIGN. Only about half of patients will achieve…
