Tomino Y, Kabuki K
Department of Medicine, School of Medicine, Juntendo University.
Nihon Rinsho. 1995 Aug;53(8):1919-24.
High dosages of nephrotoxic drugs in elderly patients might be correlated with an increase in the number of patients with tubulo-interstitial nephritis (TIN). In patients with acute TIN, marked fever, back or flank pain, CVA tenderness, skin rash, arthralgia, eosinophilia, and eosinouria are observed. Clinical symptoms might be induced by glomerular, proximal tubular or distal tubular dysfunction in chronic TIN. Mild to moderate proteinuria, edema, hypertension, azotemia, glucosuria, aminoaciduria, polyuria and polydipsia are characteristic findings in patients with chronic TIN. These findings are slowly progressive in such patients. It appears that the marked fibrosis with lymphocyte infiltration in the interstitium is a poor clinical marker in patients with TIN. Furthermore, it is important to differentiate TIN from glomerulonephritis.
老年患者使用高剂量肾毒性药物可能与肾小管间质性肾炎(TIN)患者数量增加相关。急性TIN患者会出现高热、腰背部或侧腹痛、肋脊角压痛、皮疹、关节痛、嗜酸性粒细胞增多及嗜酸性尿。慢性TIN的临床症状可能由肾小球、近端肾小管或远端肾小管功能障碍引起。轻度至中度蛋白尿、水肿、高血压、氮质血症、糖尿、氨基酸尿、多尿和烦渴是慢性TIN患者的特征性表现。这些表现在此类患者中呈缓慢进展。间质中明显的纤维化伴淋巴细胞浸润似乎是TIN患者预后不良的临床指标。此外,将TIN与肾小球肾炎区分开来很重要。