Tubulointerstitial Disease

Site of injury

Example of Acute disease

Example of chronic disease

Associated tubular dysfunction

Cortex/proximal tubule

myeloma, antibiotics

heavy metals, myeloma, SLE

proximal tubular wasting of aa's, HCO3, glu, PO4, Na, urate


NSAIDS, antibiotics

obstruction, SLE, amyloid, sickle cell

decreased K+ secretion, decreased Na+ reabsorbtion


analgesics, sickle cell, myeloma,

analgesics, metabolic disorders, amyloid, sickle cell

impaired urinary concentrating ability


infections, sickle cell

analgesics, infection, obstruction

impaired urinary concentrating ability

Mechanisms of injury:

Clinical Differentiation of upper versus lower tract disease

Interstitial Nephritis (IN)

Cystic Diseases