granulomatosis with polyangiitis may have AIN with or without diseaseassociated glomerular disease Patients with Sjögren syndrome and sarcoidosis also have increased risk Presenting symptoms are often nonspecific and may indicate generalized AKI, such as nausea and malaise Approximately 50% of patients will have oliguria Systemic symptoms such as rash or fever may be present A small portion of patients may complain of gross hematuria Clinical assessment The clinical assessment should focus on identifying potential symptoms of kidney dysfunction and possible underlying causes for AIN A detailed medication history including current and recently discontinued drugs should be obtained The physical examination should look for signs of systemic infections or diseases that could act as the causative factor Nephrotic syndrome is rare in the setting of AIN Proteinuria and edema are unlikely to be present Depending on the degree of underlying AKI, blood pressure may be normal Microscopic examination of the urine may reveal the presence of red blood cells or white blood cell casts Eosinophiluria defined by >1% eosinophils on the urine white blood cell differential may be suggestive of AIN but is not specific Furthermore, absence of this finding has poor negative predictive value Serum creatinine levels are almost universally elevated, and serum electrolytes should be measured Eosinophilia is evident on a CBC in approximately one-third of cases Management If an offending medication is identified as the likely cause, it should be discontinued immediately if not already done so Underlying infections should be treated Patients may require management of fluid, electrolyte, and acid–base disturbances, depending on the level of underlying renal dysfunction Rhabdomyolysis Goals of Treatment The goals of treatment for rhabdomyolysis include identifying and treating the underlying cause of the rhabdomyolysis, if possible The prevention of AKI should be achieved via aggressive hydration and measures aimed at the mitigation of renal and electrolyte abnormalities that occur must be taken Pain control may be required