Akute tubulointerstitielle Nephritis

Acute interstitial nephritis (AIN) is an important differential diagnosis of acute renal failure and can only be definitively proven by a biopsy. An AIN can be triggered by many medications, infections and systemic diseases. The very heteregeneous mixture of trigger mechanisms partially explains why the evidence for AIN is derived exclusively from retrospective studies. What is clear is that the triggering noxae must be removed and the underlying disease must be treated. From retrospective studies and case collections it is not clear whether glucocorticoid therapy is beneficial in AIN. A meta-analysis is not possible because so far no randomized and controlled studies have been carried out. Until proven to the contrary, it appears that interstitial nephritis should be treated with rapidly tapered steroids.