Acute Interstitial Nephritis Due to Cefepime

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Clinical Pearls:

-Use FENa only to differentiate between prerenal AKI and ATN only in oliguric patients without CKD who are not on diuretics

-Vancomycin renal toxicity is more likely when trough levels are >15 and it is administered with Zosyn or nephrotoxins such as aminoglycosides

-Classic triad of AIN: fever, maculopapular rash, and peripheral eosinophilia is only present in 10% of AIN patients

– Eosinophiluria is neither sensitive nor specific for AIN

– AIN is a clinical diagnosis: Elevated Cr temporally correlating with AIN-inducing drug exposure with improvement after discontinuation of the drug. Renal biopsy is the gold standard of diagnosis, but usually not required.

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