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This Concept Map, created with IHMC CmapTools, has information related to: tubulointerstitial disease and drug nephrotoxicity, amphotericin-B nephrotoxicity can lead to acute renal failure ARF, aminoglycosides nephrotoxicity based on NH4+ charge amts (neomycin > gentamycin > tobramycin > amikacin > streptomycin), amphotericin-B nephrotoxicity assctd distal renal tubule dysfunction impaird acidification impaird conc ability K and Mg wasting, analgesic abuse nephropathy AAN Dx: must have both chronic tubulointerstitial nephritis (CTIN), acute tubulonephritis ATN can lead to acute renal failure ARF, radiocontrast-induced ARF histo lesion consistent w/ acute tubulonephritis ATN, gadolinium contrast agents can lead to nephrogenic systemic fibrosis, drug-induced acute interstitial nephritis AIN e.g. beta-lactam antibiotics NSAIDs, RBC casts WBC casts Dx AGN, chronic tubulointerstitial nephritis (CTIN) clinical manisfestations depend on location on nephron affected, chronic tubulointerstitial nephritis (CTIN) most cmn drug- induced CTIN analgesic abuse nephropathy AAN, drug-induced acute interstitial nephritis AIN Tx stop drug if ARF persists after 2-3wk, corticosteroids, granular and tubular epi cell casts Dx acute tubulonephritis ATN, aminoglycosides in hospitals, most cmn cause of acute renal failure ARF, resolution of ARF after stop of suspected drug Dx drug-induced acute interstitial nephritis AIN, aminoglycosides amts retained in prox tblr cells induce acute tubulonephritis ATN, aminoglycosides Tx discontinue drug maintain fluid/electrolyte balance, radiocontrast-induced ARF feature rare in pt w/ nrml kidney functn, aminoglycosides used for gm-neg septicemia, acute tubulonephritis ATN histo hallmark renal tubular epi cells in urine