Nephrogenic Diabetes Insipidus and Distal Tubular Acidosis in Methicillin-Induced Interstitial Nephritis

  • Ph. Vigeral
  • A. Kanfer
  • S. Kenouch
  • F. Blanchet
  • B. Mougenot
  • J. Ph. Méry
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 212)


Acute interstitial nephritis associated with methicillin therapy has been reported in over 100 patients (1) and new cases are usually no more reported. Although its clinical picture has been extensively described (2–5), little attention has been paid to the possible occurrence of functional impairment of the distal tubule. This report deals with two patients with methicillin-induced interstitial nephritis and renal failure in whom distal tubular abnormalities were prominent.


Interstitial Nephritis Nephrogenic Diabetes Insipidus Acute Interstitial Nephritis Distal Renal Tubular Acidosis Mild Renal Insufficiency 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    G.B. Appel, A decade of penicillin related acute interstitial nephritis - more questions than answers, Clin. Nephrol. 13: 151 (1980).PubMedGoogle Scholar
  2. 2.
    D.S. Baldwin, B.B. Levine, R.T. McCluskey and G.R. Gallo, Renal failure and interstitial nephritis due to penicillin and methicillin, New Engl. J. Med. 279: 1245 (1968).PubMedCrossRefGoogle Scholar
  3. 3.
    C. Mayaud, A. Kanfer, O. Kourilsky and J.D. Sraër, Interstitial nephritis after methicillin (letter to the Editor), New Engl. J. Med. 292: 1132 (1975).PubMedGoogle Scholar
  4. 4.
    J. Ditlove, P. Weidmann, M. Bernstein and S.G. Massry, Methicillin nephritis, Medicine 56: 483 (1977).PubMedCrossRefGoogle Scholar
  5. 5.
    D. Kleinknecht, A. Kanfer, L. Morel-Maroger and J.Ph. Méry, Immunologically mediated drug-induced acute renal failure, Contr. Nephrol. 10: 42 (1978).Google Scholar
  6. 6.
    A.J. Woodroffe, N.M. Thomson, R. Meadows and J.R. Lawrence, Nephropathy associated with methicillin administration. Austr. N. Z. J. Med. 4: 256 (1974).CrossRefGoogle Scholar
  7. 7.
    W.A. Border, D.H. Lehman, J.D. Egan, H.J. Sass, J.E. Glode and C.B. Wilson, Anti-tubular basement membrane antibodies in methicillinassociated interstitial nephritis. New Engl. J. Med. 291: 381 (1974).PubMedCrossRefGoogle Scholar
  8. 8.
    C.M. Nolan and R.S. Abernathy, Nephropathy associated with methicillin therapy, Arch. Intern. Med. 137: 997 (1977).PubMedCrossRefGoogle Scholar
  9. 9.
    D. Ellis, W.A. Fried, E.J. Yunis and E.B. Blau, Acute interstitial nephritis in children: a report of 13 cases and review of the literature, Pediatrics 67: 862 (1981).PubMedGoogle Scholar
  10. 10.
    M.C. Cogan and A.I. Arieff, Sodium wasting, acidosis and hyperkalemia induced by methicillin interstitial nephritis, Amer. J. Med. 64: 500 (1978).PubMedCrossRefGoogle Scholar
  11. 11.
    W.B. Schwartz, P.W. Hall, R.M. Hays and A.S. Relman, On the mechanism of acidosis in chronic renal failure, J. Clin. Invest. 38: 39 (1958).CrossRefGoogle Scholar
  12. 12.
    H.C. Gonick, C.R. Kleeman, M.E. Rubini and M.H. Maxwell, Functional impairment in chronic renal disease II. Studies of acid excretion, Nephron 6: 28 (1969).PubMedCrossRefGoogle Scholar
  13. 13.
    R.L. Tannen, E.M. Regal, M.J. Dunn and R.W. Schrier, Vasopressinresistant hyposthenuria in advanced renal disease, New Engl. J. Med. 280: 1135 (1969).PubMedCrossRefGoogle Scholar
  14. 14.
    M.A. Holliday, T.J. Egan, C.R. Morris, A.S. Jarrah and J.L. Harrah, Pitressin-resistant hyposthenuría in chronic renal disease. Amer. J. Med. 42: 378 (1967).PubMedCrossRefGoogle Scholar
  15. 15.
    N.S. Bricker and L. Fine, The renal response to progressive nephron loss, in “The Kidney”, B.M. Brenner and F.C. Rector, ed., Saunders, Philadelphia (1981).Google Scholar
  16. 16.
    G. Conte, A. Dal Canton, G. Fuiano, M. Terribile, M. Sabbatini, M. Balletta, P. Stanziale and V.E. Andreucci, Mechanism of impaired urinary concentration in chronic primary glomerulonephritis, Kidney Int. 27: 792 (1985).PubMedCrossRefGoogle Scholar
  17. 17.
    N.S. Bricker, R.R. Dewey, H. Lubowitz, J. Stokes and T. Kirkensgaard, Observations on the concentrating and diluting mechanisms of the diseased kidney, J. Clin. Invest. 38: 516 (1959).PubMedCrossRefGoogle Scholar
  18. 18.
    R.L. Zerbe and G.L. Robertson, A comparison of plasma vasopressin measurements with a standard indirect test in the differential diagnosis of polyuria, New Engl. J. Med. 305: 1539 (1981).PubMedCrossRefGoogle Scholar
  19. 19.
    W. Pruszczynski, H. Caillens, L. Drieu, L. Moulonguet-Doleris and R. Ardaillou, Renal excretion of antiduretic hormone in healthy subjects and patients with renal failure, Clin. Sci. 67: 307 (1984).PubMedGoogle Scholar
  20. 20.
    J.P. Fillastre, R. Ardaillou and G. Richet, pH et pCO2 urinaires en réponse à une surcharge alcaline au cours de l’insuffisance rénale chronique, Nephron 6: 91 (1969).PubMedCrossRefGoogle Scholar
  21. 21.
    M.L. Halperin, M.B. Goldstein, A. Haid, M.D. Johnson and B.J. Stinebaugh, Studies on the pathogenesis of type 1 (distal) renal tubular acidosis as revealed by the urinary pCO2 tensions, J. Clin. Invest. 49: 596 (1974).Google Scholar
  22. 22.
    D. Battle, M. Grupp, M. Gaviria and N.A. Kurtzman, Distal renal tubular acidosis with intact capacity to lower urinary pH, Amer. J. Med. 72: 751 (1982).CrossRefGoogle Scholar
  23. 23.
    M.L. Halperin, M.B. Goldstein, R.M.A. Richardson and B.J. Stinebaugh, Distal renal tubular acidosis syndromes: a physiopathological approach, Amer. J. Nephrol. 5: 1 (1985).CrossRefGoogle Scholar

Copyright information

© Plenum Press, New York 1987

Authors and Affiliations

  • Ph. Vigeral
    • 1
    • 2
  • A. Kanfer
    • 1
    • 2
  • S. Kenouch
    • 1
    • 2
  • F. Blanchet
    • 1
    • 2
  • B. Mougenot
    • 1
    • 2
  • J. Ph. Méry
    • 1
    • 2
  1. 1.Service de Néphrologie and Laboratoire d’Explorations FonctionnellesHôpital BichatParisFrance
  2. 2.Laboratoire d’Anatomie et de Cytologie PathologiquesHôpital TenonParisFrance

Personalised recommendations