Tubulointerstitial Diseases

What are tubulointerstitial diseases?

Tubulointerstitial diseases include several conditions that affect the tubules and interstitial tissues inside your kidneys. Your kidneys have structures that filter your blood. Then the blood flows through tubules inside the kidneys that return essential substances back to your bloodstream and remove wastes. The interstitial tissues surround the tubules.

The very nature of the job performed by your kidneys exposes the tubules and interstitial tissues to high amounts of toxins, medications, and biochemicals. As a result, they can develop the inflammation and tissue damage that characterizes tubulointerstitial disease. 

Tissue damage affects the kidneys’ ability to function. In severe cases, tubulointerstitial diseases lead to kidney failure.

What type of tubulointerstitial diseases might I develop?

These diseases fall into two primary categories:

Acute tubular necrosis

Acute tubular necrosis occurs when the tubules suffer damage. The condition arises from low blood pressure, acute pancreatitis, sepsis (bodywide inflammation), and toxins.

Many different toxins can lead to tubular damage. The long list includes poisons such as ethylene glycol (antifreeze), chemotherapy drugs, overuse of nonsteroidal anti-inflammatory drugs (NSAIDs), and other medications.

Tubulointerstitial nephritis (interstitial nephritis)

Tubulointerstitial nephritis generally refers to kidney damage that occurs outside the structures that filter your blood. The most common type, interstitial nephritis, may appear as an acute or chronic disease.

Acute interstitial nephritis develops over days or a few weeks due to a drug reaction or infection. Chronic interstitial nephritis (CIN) builds up over months and years.

CIN arises from many possible causes, including:

• Allergic reaction to drugs
• Autoimmune disorders
• Recurrent infections
• Medication side effects
• Overuse of acetaminophen, aspirin, or NSAIDs
• Long-term exposure to toxins (heavy metals)
• Electrolyte disorders (too little potassium or too much calcium)

Autoimmune diseases that affect your kidneys include systemic lupus erythematosus and lupus nephritis.

What symptoms develop due to tubulointerstitial diseases?

The most common symptoms include: 

• Blood in your urine
• Fatigue
• Fever
• Confusion
• Drowsiness
• Nausea
• Vomiting
• Rash
• Swelling and bloating (water retention)
• Urinating more or less than usual

Urinating less often is a sign of acute kidney failure.

How are tubulointerstitial diseases treated?

After performing diagnostic tests to determine the type and severity of your tubulointerstitial disease, your Renal Clinic of Houston provider treats the underlying cause. They may also prescribe medications such as steroids to relieve inflammation.

Treating the underlying cause often involves removing toxins and medications. You may need dietary support or supplements to restore electrolytes or medications to treat associated problems like high blood pressure.

If you need expert care for tubulointerstitial disease, call the Renal Clinic of Houston or request an appointment online today.