AJKD Atlas of Renal Pathology: Chronic Interstitial Nephritis.
Published Jul 1, 2017 · A. Fogo, Mark A. Lusco, Behzad Najafian
American journal of kidney diseases : the official journal of the National Kidney Foundation
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Abstract
Chronic interstitial nephritis is a nonspecific diagnosis of a pattern of kidney injury, which may occur due to any of many conditions that initially cause an acute interstitial nephritis. The diagnosis is made when specific underlying causes cannot be identified. Patients may present at any age, usually with low-grade proteinuria and slowly progressive decline in glomerular filtration rate, and may reach end-stage kidney disease. Fanconi syndrome may be present, with glycosuria and aminoaciduria. Light microscopy: Biopsies show chronic interstitial nephritis with a lymphoplasmacytic infiltrate out of proportion to the degree of interstitial fibrosis and tubular atrophy. The infiltrate consists of CD4/CD8 T-cells, B-cells, and plasma cells, with scattered tubulitis. Glomeruli are initially unremarkable, but may show periglomerular fibrosis and ischemic wrinkling of glomerular basement membranes and even sclerosis in advanced cases. Vascular sclerosis and hyalinosis may be present. Immunofluorescence microscopy: No specific staining. Electron microscopy: No specific changes.