Renal · Year 2 · from Renal

Case 3: Acute Interstitial Nephritis from Proton Pump Inhibitor

Patient Presentation

A 54-year-old female presents with fatigue and mild flank discomfort. Laboratory studies ordered for pre-operative evaluation (elective knee replacement) revealed unexpected renal dysfunction.

History of Present Illness

  • Routine pre-operative labs showed elevated creatinine
  • Mild bilateral flank discomfort for 2 weeks
  • No dysuria or gross hematuria
  • Started omeprazole 20 mg daily 3 months ago for GERD
  • No recent antibiotic use
  • No fever or rash reported

Physical Examination

  • Blood pressure: 138/84 mmHg
  • Heart rate: 76 bpm
  • Temperature: 37.0°C
  • No rash
  • Mild bilateral costovertebral angle tenderness
  • No peripheral edema

Workup

Laboratory Studies:

  • Creatinine 1 year ago: 0.9 mg/dL
  • Current creatinine: 2.4 mg/dL
  • BUN: 34 mg/dL
  • WBC: 8,200/mcL with 6% eosinophils (480/mcL)
  • Urinalysis: 2+ protein, 25 WBC/hpf, no bacteria, occasional WBC casts
  • Urine eosinophils: Present (though low sensitivity)
  • Urine culture: Negative

Renal Biopsy:

  • Interstitial edema with lymphocytic infiltrate and scattered eosinophils
  • Tubulitis present
  • No granulomas
  • Glomeruli normal

Diagnosis

Proton Pump Inhibitor-Induced Acute Interstitial Nephritis

Discussion

This case illustrates drug-induced AIN:

  • PPI-Associated AIN: The lecture notes that PPIs have emerged as an increasingly recognized cause of AIN, often with insidious onset weeks to months after starting therapy (unlike the 1-3 week onset typical of beta-lactams).
  • Classic Triad Absent: The lecture emphasizes that the complete triad of fever, rash, and eosinophilia occurs in <10% of cases. This patient had only mild eosinophilia.
  • Sterile Pyuria with WBC Casts: These findings support interstitial inflammation rather than infection. WBC casts are characteristic of AIN, as noted in the lecture.
  • Idiosyncratic Reaction: AIN is not dose-dependent; it represents a type IV hypersensitivity reaction where the drug acts as a hapten.
  • Biopsy Findings: Interstitial edema, lymphocytic infiltrate, tubulitis, and eosinophils confirm the diagnosis.

Treatment

  • Discontinue omeprazole
  • Switch to H2 blocker (famotidine) for GERD
  • Observe for improvement over 1 week
  • If no improvement, start prednisone 1 mg/kg/day for 2-4 weeks with taper
  • Elective surgery postponed until renal function improves
  • Creatinine improved to 1.3 mg/dL at 3 weeks

Clinical Pearl

PPI-induced AIN has a longer latency period (weeks to months) compared to classic antibiotic-induced AIN. The absence of fever and rash is common, making clinical suspicion essential. Withdrawal of the offending agent is the cornerstone of treatment; steroids may accelerate recovery if improvement does not occur within 1 week.


Image Reference

For visual reference of AKI concepts, see:


Learning Points

  1. FENa Distinguishes Prerenal from ATN: FENa <1% with concentrated urine suggests prerenal AKI with intact tubular function; FENa >2% with isosthenuria suggests ATN.
  1. Urinary Sediment is Diagnostic: Bland sediment (hyaline casts only) supports prerenal; muddy brown casts indicate ATN; WBC casts suggest AIN or pyelonephritis.
  1. Drug-Induced AIN Classic Triad is Rare: Fever, rash, and eosinophilia together occur in <10% of cases. Maintain suspicion based on timing and clinical context.
  1. PPIs Have Delayed Onset AIN: Unlike beta-lactams (1-3 weeks), PPI-induced AIN may develop months after starting therapy.
  1. AEIOU for Dialysis Indications: Acidosis (refractory), Electrolytes (hyperkalemia), Intoxication (dialyzable toxins), Overload (volume), Uremia (symptomatic) - memorize these indications for emergency dialysis.

All cases for this lecture as Markdown