As with many categories of renal disease, tubulointerstitial nephropathy represents an admixture of morphologic and functional terms. Thus, it is a hybrid term used to simultaneously denote a disease entity that possesses unique clinical and histologic features. While the former are easily tabulated and compared with uniform clinically derived criteria, the latter requires sampling of renal tissue, which is less often available. For the purist, combined clinical-histologic criteria are mandatory and yet extenuating circumstances may preclude an invasive procedure. This should not lead to abandonment of the term, which has significant conceptual implications, as detailed by Cotran in Chapter 17, but rather it should be applied with caution in patients without histologic confirmation. Clearly, both clinical and histologic criteria must be accepted to define tubulointerstitial nephropathy, since the most global definition would include all renal parenchymal disease after excluding glomerulopathies and pyelocalyceal disease.
KeywordsInterstitial Nephritis Acute Tubular Necrosis Minimal Change Nephrotic Syndrome Acute Interstitial Nephritis Tubulointerstitial Nephritis
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