How do you tell the difference between AIN and ATN?

[Bevo]

I'm getting confused between Acute Interstitial Nephritis and Acute Tubular Necrosis?

Only difference I know about is the eosinophils assocaited with AIN, but I hardly ever see that mentioned in the question stem

Usually the question involves the patient taking some drug like amoxicillin which I thought could cause both

---

Members don't see this ad.

 

[Idiopathic]

AIN is the only board-worthy cause of eosinophiliuria that I know of (outside of UTI), and its almost always associated with medications like NSAIDS or ABX

There is a classic triad I think thats like rash, fever, arthralgia but thats pretty nonspecific. They will tell you that a px started ampicillin/ibuprofen/etc 5 days ago and now presents with nonspecific somatic complaints and eosinophiliuria...slam-dunk from there.

 

[Isoniazid]

Idiopathic is pretty much spot on....AIN is characterized by fever, rash, and eosinophils in the urine (also seen in serum) and is associated with a drug rxn...most commonly ABX or NSAIDS

The only other relevant thing that can present with eosinophils in the urine in a cholesterol embolus...which is usually presented as renal failure with recent history of vascular catherization.

Hope this helps.