Tubulointerstitial Nephropathies

Abstract Tubulointerstitial nephropathies encompass diverse disease processes involving the part of the renal parenchyma that consists of the tubules and interstitium. Tubulointerstitial diseases can occur as primary or secondary (to a systemic disease) processes, and patients can present with either acute or chronic disease. Depending on the offending agent, the disease may have a particular predilection for the proximal tubules, the distal tubules, or both. Definitive diagnosis is by renal biopsy, which typically reveals variable degrees of cellular infiltration of the interstitium, tubular atrophy, and fibrosis, depending on the chronicity. There are several causes, including drugs, infections, environmental toxins, and immunologic processes. This chapter classifies tubulointerstitial nephropathies and briefly discusses the important individual entities. In addition, an approach for renoprotection in these cases based on the available data is suggested.