Acute interstitial nephritis

The most important preventative action is to avoid exposure to the trigger of the acute episode. If the triggering medication has clearly been identified, then avoiding future use of the medication is recommended, because acute interstitial nephritis (AIN) may recur on re-exposure to the original antigen.

Where known cross-reactivity exists, for example between penicillins and cephalosporins, the risk of using a related agent should be carefully weighed up against the benefit of using it. If such an agent is used, the patient should be appropriately monitored for any adverse effects.

For the few patients who have chronic inflammatory diseases such as Sjogren syndrome, sarcoidosis, or systemic lupus erythematosus, adequate control of the underlying condition is important.

Rechallenge after immune checkpoint inhibitor related AIN remains an active area of research and such decisions should be made in conjunction with the oncologist and accounting for patient's choice.