Kimura K
2nd Department of Internal Medicine, Faculty of Medicine, University of Tokyo.
Nihon Rinsho. 1995 Aug;53(8):1931-8.
Tubulo-interstitial nephropathy or nephritis is suggested if renal function is deteriorated and urinary findings are slight. In most cases, the daily urinary protein excretion is less than 1 g and macrohematuria is not present. Urinary excretion of N- acetyl-beta-glucosaminidase and beta 2-microglobulin is a good indicator for tubulo-interstitial damage. Acute renal failure is caused either by acute tubulo-interstitial nephritis or acute tubular necrosis. In either case, renal biopsy is essential for diagnosis and to characterize the renal damage. In the interstitium, edema and fibrosis are seen and lymphocytes, plasma cells, polymorpholeukocytes, and/or eosinophils infiltrate. Tubular basement membrane is sometimes disrupted and lymphocytes have infiltrated inside (tubulitis).
如果肾功能恶化而尿液检查结果轻微，则提示存在肾小管间质性肾病或肾炎。在大多数情况下，每日尿蛋白排泄量少于1g，且无肉眼血尿。N-乙酰-β-葡萄糖苷酶和β2-微球蛋白的尿排泄是肾小管间质损伤的良好指标。急性肾衰竭由急性肾小管间质性肾炎或急性肾小管坏死引起。在任何一种情况下，肾活检对于诊断和明确肾损伤特征都至关重要。在间质中，可见水肿和纤维化，并有淋巴细胞、浆细胞、多形核白细胞和/或嗜酸性粒细胞浸润。肾小管基底膜有时会被破坏，淋巴细胞侵入内部（肾小管炎）。
