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  • Renal tubulointerstitial diseases is a group of kidney diseases, specifically involving the interstitium and tubules, that develop as a result of primary injury or inflammation and which progress to decreased renal function. The glomeruli may be affected only late in the disease course or not at all. Two classes of tubulointerstitial disease: 1. Acute tubulointerstitial disease: Develops over days to months; characterized by inflammatory infiltrate and edema that affect the renal interstitium; leads to acute renal insufficiency or failure; in severe cases can lead chronic renal failure and/or permanent renal injury; principal etiologies: infections; drugs. 2. Chronic tubulointerstitial disease: can gradually develop over years; involves interstitial infiltrate, fibrosis, tubular atrophy and dysfunction, and eventually renal dysfunction; interstitial inflammation and scarring of the renal parenchyma is associated with gross changes, including papillary blunting and marked calyceal deformities; can be detected by imaging; systemic insults, such as genetic disorders, hypertension, toxins, etc., feature symmetric and bilateral disease; other causes of chronic disease may result in unequal renal scarring, and may involve one or both kidneys; principal etiologies include: toxins; drugs; autoimmune, genetic, and neoplastic disorders; obstructive uropathy.
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