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INTRODUCTION

Tubulointerstitial diseases constitute a diverse group of acute and chronic, hereditary and acquired disorders involving the renal tubules and supporting structures (Table 153-1). Functionally, they may result in a wide variety of physiologic phenotypes, including nephrogenic diabetes insipidus (DI) with polyuria, non-anion-gap metabolic acidosis, salt wasting, and hypo- or hyperkalemia. Azotemia is common, owing to associated glomerular fibrosis and/or ischemia. Compared with glomerulopathies, proteinuria and hematuria are less dramatic, and hypertension is less common. The functional consequences of tubular dysfunction are outlined in Table 153-2.

TABLE 153-1PRINCIPAL CAUSES OF TUBULOINTERSTITIAL DISEASE OF THE KIDNEY
TABLE 153-2TRANSPORT DYSFUNCTION IN TUBULOINTERSTITIAL DISEASE

ACUTE INTERSTITIAL NEPHRITIS (AIN)

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