there are Primary and Secondary types, and, acute or chronic Types.
The primary categories of tubulointerstitial disease are acute tubular necrosis and acute or chronic tubulointerstitial nephritis.
Primary tubulointerstitial diseases of the kidney are characterized by
histologic and functional abnormalities that involve the tubules and
interstitium to a greater degree than the glomeruli and renal vasculature.
Secondary tubulointerstitial disease occurs as a consequence of progressive glomerular or vascular injury. Morphologically, acute forms of these disorders are characterized by interstitial edema, often associated with cortical and medullary infiltration by
both mononuclear cells and polymorphonuclear leukocytes, and
patchy areas of tubule cell necrosis.
So now we have to place/ or assign them correctly with the exact documentation, which correlates to the pathological processes going on
I feel 584.5 has most of the answer for tubular necrosis.
Tubulointerstitial diseases are clinically heterogeneous disorders that share similar features of tubular and interstitial injury. In severe and prolonged cases, the entire kidney may become involved, with glomerular dysfunction and even renal failure.
The kidneys are exposed to unusually high concentrations of toxins