Intrinsic Renal Causes
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Intrinsic renal disease is best divided into the compartment it affects. Diseases can affect one or more compartment:
Glomerulus (glomerulonephritis)
- Vasculitis
- Anti–glomerular basement membrane (anti-GBM) disease (Goodpasture's)
- Systemic lupus erythematous
- Immunoglobulin A nephropathy
- Post-infectious glomerulonephritis
Tubules
Obstruction of the tubules:
- Myeloma casts
- Crystals, e.g. urate, oxalate, acyclovir
- Pigment casts secondary to rhabdomyolysis
Tubular injury:
- Myeloma
- Acute tubular necrosis
- Aminoglycosides
- Radiographic contrast
- Rhabdomyolysis
Interstitium
- Pyelonephritis
- Interstitial nephritis which can be caused by drugs, e.g. antibiotics, NSAIDs, proton pump inhibitors (PPI)
- Infiltration by malignancy or sarcoidosis
Vessels
- Vasculitis
- Thrombotic microangiopathy; some causes of which include:
- Accelerated hypertension
- Haemolytic-uraemic syndrome (HUS)
- Thrombotic thrombocytopenic purpura (TTP)
- Microvascular injury secondary to cholesterol emboli