Interstitial nephritis quinolones

Early reports of acute interstitial nephritis [273] and of acute tubular necrosis [274] associated with the use of pirotnidic acid (a non-fluorinated quinolone available in Europe) have been published. At large dosage, crystals of norfloxacin can be occasionally seen in freshly voided urine, this, however, does not... 

It is reasonable to conclude that in general, quinolones are safe drugs from the renal point of view. It is often difficult, however, to ascertain the exact causative role of these agents in the appearance of nephrotoxicity. Judging by the recent accumulated experience with ciprofloxacin, physicians using quinolones should be alert for the development of acute interstitial nephritis leading to renal failure. This concern should be extended to the other newer fluoroquinolones despite the paucity of reports dealing with nephrotoxicity. 

Gauffre A, Mircheva J, Glotz D, Fillastre JP, Simon P, Beaune PH, et al. Autoantibodies against a kidney-liver protein associated with quinolone-induced acute interstitial nephritis or hepatitis. Nephrol Dial Transplant. 1997 Sep 12(9) 1961-2. 

Although the pathogenesis of dprofloxacin-induced acute interstihal nephritis is not clear, it has been attributed to an inflammatory interstitial response secondary to the crystalluria associated with the quinolone (foreign body response) [232, 238, 248]. Crystalluria and the presence of crystals of dprofloxacinin the renal tissue have been shown in animal experiments. The species studied (rats, monkeys, dogs), however, have alkaline urine, and because the quinolone solubihty is... 

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