7537 - Interstitial nephritis

DBQ: Link to Index of DBQ/Exams by Disability for DC 7537

Acronyms: IN, ITN

Definition

The inflammation involves mainly the supporting components of the kidney within spaces of the organ.

Etiology

Etiologic factors related to the condition include: bacteria or their toxins; streptococcal infections; diphtheria; blood poisoning (septicemia); or toxic agents such as drugs or chemicals. The condition may be acute or chronic, and is often referred to as tubulointerstitial disease.

Signs & Symptoms

Manifestations of the condition may include: blood in the urine (hematuria); protein in the urine (proteinuria); fever; rash; excess serum proteins in the blood; swelling (edema); weight gain; and high blood pressure. Other signs include: anorexia; irritability; flank (lower back) pain; constipation; polyuria; dizziness; drowsiness; blurred vision; headache; malaise; weight loss; smoky urine; and increased urine specific gravity.

Tests

Diagnostic measures include: urinalysis; blood tests; and x-ray or ultrasound examination of the kidneys. Kidney biopsy may help to determine the course of treatment.

Treatment

The following measures of treatment are utilized: hypertension is treated with high blood pressure drugs; swelling is treated with diuretics; salt and fluid intake are restricted; infections are treated with antibiotics; and kidney failure is treated with dialysis or transplant surgery.

Residuals

High blood pressure medication may be required for long-term control. Recurrent infections may require an antibiotic regimen. Complete recovery occurs in most acute cases; however, chronic kidney failure may occur which may result in life-long dialysis or kidney transplant.

Special Considerations

  • This disease, (condition), only in its active form , has a 3 year presumptive period and shall be granted service connection although not otherwise established as incurred in or aggravated by service if manifested to a compensable degree within the applicable time limits under 38 CFR 3.307 following service in a period of war or following peacetime service on or after January 1, 1947, provided the rebuttable presumption provisions of 38 CFR 3.307 are also satisfied. [38 CFR 3.309 [Disease subject to presumptive service connection], 38 CFR 3.309(a). [chronic disease].

  • May be entitled to special monthly compensation where the Veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. See  38 CFR 3.350(i)(1) – Special Monthly Compensation (SMC).

  • The new criteria for the Genitourinary Disease and Conditions body system became effective November 14, 2021.  Review both current and historic criteria prior to any reduction for disabilities established before that date.  38 CFR 3.951(a)

Notes

  • When evaluating any claim involving loss or loss of use of one or more creative organs, refer to 38 CFR 3.350 of this chapter to determine whether the Veteran may be entitled to special monthly compensation. Footnotes in the schedule indicate conditions which potentially establish entitlement to special monthly compensation; however, there are other conditions in this section which under certain circumstances also establish entitlement to special monthly compensation.

  • GFR, estimated GFR (eGFR), and creatinine-based approximations of GFR will be accepted for evaluation purposes when determined to be appropriate and calculated by a medical professional.