Korean J Nephrol.  2009 Nov;28(6):643-647.

Acute Renal Failure in Coexisting IgA Nephropathy and Acute Interstitial Nephritis: Complete Recovery after Hemodialysis and Steroid Therapy

• Lee JH
• Ryu JW
• Hong HS
• Yi JH
• Han SW
• Park MH
• Kim HJ

Abstract

Acute renal failure in Immunoglobulin A nephropathy (IgAN), a rare event, is associated with acute tubular necrosis mainly induced by intratubular erythrocytic cast and crescentic glomerulonephropathy (rapidly progressive glomerulonephritis) and the severity paralleled to the degree of glomerular damage. The changes are regarded as those of secondary atrophic response to the glomerular lesions. In that case, renal progression correlates more closely with the severity of tubulointerstitial lesions than with the degree of glomerular lesions in IgAN. Rarely, acute tubulointerstitial nephritis (TIN) could develop independently in primary glomerulonephritis. In this case, the severity of tubulointerstitial lesion was out of proportion with damage of glomerular lesion. To the best of our knowledge, we report the first case of a patient with independently developed severe acute TIN complicating IgAN in Korea. A 38-year-old man was admitted with recurrent hematuria. Proteinuria (<1 g) and severe renal failure were noted and hemodialysis was started. In renal biopsy, IgAN associated with acute TIN was diagnosed. He showed good response to steroid therapy and maintained normal renal function after discontinuation of medication.

Keyword

IgA nephropathy; Interstitial nephritis; Acute renal failure; Hematuria; Proteinuria

MeSH Terms

Acute Kidney Injury
Adult
Biopsy
Glomerulonephritis
Glomerulonephritis, IGA
Hematuria
Humans
Immunoglobulin A
Korea
Necrosis
Nephritis, Interstitial
Proteinuria
Renal Dialysis
Renal Insufficiency
Tin
Immunoglobulin A
Nephritis, Interstitial
Tin