A/Prof Robert MacGinley is a Staff Nephrologist and General Physician at Eastern Health, Melbourne and he is an Adjunct Associate Professor at Eastern Health Clinical School, Monash University. His clinical practice has mainly been in acute medicine across Renal, Internal and ICU Medicine.His main research interests over 20 years has been in Vascular Biology, Hypertension, diet and disease, CKD and AKI and has published across the field of quantitative and qualitative research and has been involved in guidelines for nephrology in Australia and New Zealand. He has been involved in undergraduate and post graduate education across both early university years to the college of physicians training for registrars and consultants in Assessment, Teaching and Learning.
Acute interstitial nephritis (AIN) is a rare cause of kidney injury and is characterized by inflammatory infiltrates within the interstitial. AIN is most often induced by induced by drugs, particularly antimicrobial agents and proton pump inhibitors and more recently the oncology agents checkpoint inhibitors. The typical presentation is rapid impairment of kidney function associated with mild proteinuria but continued urine output. AIN is diagnosed by renal biopsy and the mainstay of therapy is discontinuation of the drug and consideration to steroid use in a short term pulse. Less often we have come to understand the other cause of AIN including infection associated, connective tissue associated, vasculitis associated, genetic associated and idiopathic.