Acute interstitial nephritis associated with thiazide diuretics

Diuretics

“…However, in the patient reported by Lyons et al [32], JULES B. PUSCHETT removal of furosemide and replacement with ethacrynic acid was successful as was the case in a patient reported by Fuller et al [34]. Magil and his coworkers noted the development of eosinophilia and fever in a total of three patients receiving a combination of hydrochlorothiazide and tri amterene , as well as oligurie acute renal failure in one of them [35]. Biopsies of these three patients demonstrated acute interstitial nephritis.…”

“…Furthermore, the renal failure may be nonoligurie [46]. An interesting feature of the patients reported by Kleinknecht et al [44] and Magil and his coworkers [35,47] was the presence in the biopsy of noncaseating Figure 2. Sequential renal biopsies, separated by 10 years, in a patient with hypokalemia related to chronic diuretic abuse.…”

Triamterene Crystalline Nephropathy

“…10,11 Acute allergic interstitial nephritis has been reported in a few patients treated with conventional doses of triamterene alone or triamterene combined with hydrochlorothiazide. 12,13 Although triamterene crystalluria is common, triamterene crystalline nephropathy is very rare, with only 2 histologically proven cases reported to date. Roy et al 14 reported the case of a 66-year-old patient with congestive heart failure who presented with acute oliguric kidney injury.…”

Diuretics for the Treatment of Hypertension

“…Acute allergic interstitial nephritis with fever, rash, and eosinophilia, although an uncommon complication of diuretics, is one that may result in permanent renal failure if the drug exposure remains prolonged [ 111 ]. Allergic interstitial nephritis may develop abruptly or some months after therapy is begun with a thiazide diuretic or, less commonly, with a loop diuretic such as furosemide [ 112 ].…”