Karyomegalic interstitial nephritis

A 44-year-old white man was admitted to hospital for kidney biopsy, with progressive chronic kidney disease with mild proteinuria. Histological preparations showed bizarrely enlarged nuclei of proximal tubular epithelial cells, tubular atrophy, and interstitial fibrosis (figure).Clinically, karyomegalic interstitial nephritis is characterised by slow progressive renal failure in the absence of urinary sediment abnormalities, leading to end-stage...