How is AIN diagnosed?

Renal biopsy is the gold standard for diagnosis of AIN, with the typical histopathologic findings of plasma cell and lymphocytic infiltrates in the peritubular areas of the interstitium, usually with interstitial edema. Renal biopsy is not needed in all patients.

What is AIN urine?

Acute interstitial nephritis (AIN) is a renal lesion that typically causes a decline in kidney function and is characterized by an inflammatory infiltrate in the kidney interstitium [1]. It is most often induced by drug therapy.

What do casts in urine indicate?

Urinary casts are microscopic clusters of urinary particles, such as cells, fat bodies, or microorganisms, wrapped in a protein matrix and found in the urine. Urinary casts serve as clinical indicators of kidney condition and can be assessed to determine the functioning of the kidneys.

What is hyaline casts in urine mean?

Casts are clusters of urinary sediment elements (red blood cells, white blood cells, fat bodies, etc.) wrapped in a protein matrix. Cast formation necessarily occurs in the kidney tubules, and the the contents of the casts indicate the nature of the abnormalities occurring in the kidney itself.

Is AIN reversible?

The early diagnosis of AIN by detecting tubular dysfunction (Figure 4) is central to its diagnosis at a potentially reversible stage [46, 47].

How do you treat AIN?

Topical treatments such as Imiquimod, Cidofovir and 5-Fluorouracil and ablative treatments such as electrocautery, laser therapy and radiofrequency ablation can all be used to treat AIN. People diagnosed with HPV associated AIN may also be considered for vaccination against multiple strains of HPV.

What is drug-induced AIN?

Drug-induced acute interstitial nephritis (AIN) is a relatively common cause of hospital-acquired acute kidney injury (AKI). While prerenal AKI and acute tubular necrosis (ATN) are the most common forms of AKI in the hospital, AIN is likely the next most common.

What are the different types of casts in urine?

Urinary Casts

Type	Description
Plain casts
Hyaline	Glycoprotein matrix consisting mainly of Tamm-Horsfall protein secreted by tubules
Waxy	Glycoprotein matrix with degraded protein Formed in atrophic tubules Highly refractile with waxy appearance
Casts with inclusions

What does high casts in urine mean?

Fatty casts are seen in people who have lipids in urine. This is most often a complication of nephrotic syndrome . Granular casts are a sign of many types of kidney diseases. Red blood cell casts mean there is a microscopic amount of bleeding from the kidney. They are seen in many kidney diseases.

What is the normal range for hyaline casts in urine?

Casts: Casts are formed in the tubules of they kidney when the tubules secrete a protein called Tamm-Horsfall protein. The origin of the casts causes them to take on a tubular or hotdog-like shape. These casts are known as hyaline casts and can be present in normal adults on the order of 0-5 per LPF.

What are some examples of abnormal findings in a urinalysis?

Cloudiness or an unusual odor can indicate a problem, such as an infection. Protein in urine can make it appear foamy. Blood in the urine can make it look red or brown. Urine color can be influenced by what you’ve just eaten or by certain drugs you’re taking.

What medicines cause AIN?

While any drug may cause AIN, classic and common agents are certain antimicrobial agents (β-lactams, sulfonamides, quinolones, anti-viral agents), anti-ulcer agents (proton pump inhibitors [PPIs], H2-antagonists), non-steroidal anti-inflammatory drugs (NSAIDs), anticonvulsants, and allopurinol [8, 9].

Is AIN the same as ATN?

As a clinical condition characterized by an acute onset of kidney injury, the principal differential diagnosis of AIN is its differentiation from ATN.

Is AIN treatable?

AIN can be treated using topical therapies such as imiquimod, 5-flurouracil, and trichloroacetic acid, as well as ablative therapies such as electrocautery and laser therapy.

Can AIN cause ATN?

In fact, AIN is estimated to be the cause of AKI in 10–27% of hospitalized patients, making it the third most common etiology of hospital-acquired AKI, behind acute tubular necrosis (ATN) and prerenal AKI [1–6] (Figure 1).

What types of casts are there?

Types of casts

• Plaster cast. This is made from gauze and plaster strips soaked in water.
• Synthetic cast. This is made from fiberglass or plastic strips.
• Cast brace. This is made of hard plastic.
• Splint (also called a half cast). This is made from slabs of plaster or fiberglass that hold the injury still.

How many casts are there in urine?

Where are casts formed?

distal convoluted tubules
Casts are cylindrical bodies formed either in the distal convoluted tubules or the collecting ducts of the kidney.

What bacteria causes positive nitrite in urine?

A positive result on the nitrite test is highly specific for UTI, typically because of urease-splitting organisms, such as Proteus species and, occasionally, E coli; however, it is very insensitive as a screening tool, as only 25% of patients with UTI have a positive nitrite test result.