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l 1 lubular interstitial structures of the kidney are particularly vulnerable in face of toxic compounds. High concentration of the toxics in de medulla as well as medullary hypoxia and renal hypoperfusion could explain this particularity. Clinical nephrotoxicity involves toxins of diverse origin. The culprits are often registered and non registered drugs either prescribed or purchased over the counter. Other major causes result from occupational and industrial exposures. Sometimes, the identification of the nephrotoxin requires astuteness and long investigations especially in cases of environmental toxins or prolonged intake of unregulated drugs or natural products. A correct diagnosis of the causes is, however, the key for future prevention of renal diseases. The diagnosis of "chronic interstitial nephritis of unknown origin" should, therefore, no longer be used.

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