Drug- and heavy-metal-induced tubulo-interstitial and tubular conditions
Chapter 14:Diseases of the genitourinary system
ICD-10 N14 is a billable code used to indicate a diagnosis of drug- and heavy-metal-induced tubulo-interstitial and tubular conditions.
N14 encompasses a range of renal conditions primarily caused by exposure to drugs and heavy metals, leading to tubulo-interstitial and tubular damage. This includes drug-induced nephropathy, which can manifest as acute interstitial nephritis or pyelonephritis, often characterized by inflammation of the renal interstitium and tubules. Common culprits include nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics, and heavy metals like lead and mercury. Symptoms may include flank pain, fever, and dysuria, with potential progression to hydronephrosis if urinary obstruction occurs. Diagnosis typically involves urinalysis, imaging studies, and renal function tests. Management may require discontinuation of the offending agent, supportive care, and in some cases, antibiotic therapy for secondary infections. Understanding the underlying cause is crucial for effective treatment and prevention of further renal impairment.
Detailed history of drug use, lab results, and imaging studies.
Patients presenting with acute renal failure after starting new medications.
Ensure clear documentation of the timeline of drug exposure and renal function tests.
Records of urinary symptoms, imaging results, and any surgical interventions.
Patients with hydronephrosis secondary to drug-induced obstruction.
Document any interventions performed to relieve obstruction.
Used to evaluate renal function and detect urinary tract infections.
Document the reason for urinalysis and any relevant symptoms.
Nephrologists may require additional lab tests to assess renal function.
Common drugs include NSAIDs, certain antibiotics (like penicillins), and chemotherapeutic agents. Heavy metals such as lead and mercury are also significant contributors.
Focus on the patient's medication history, timing of symptom onset, and specific lab findings such as eosinophilia in urinalysis.
