Am J Kidney Dis 63 (3): 506 - 520, 2014. doi: 10.1053 / j. ajkd.2013.10.062 Symptoms and Signs of Tubulointerstitial Nephritis Acute tubulointerstitial nephritis Symptoms and signs of acute tubulointerstitial nephritis (ATIN) may be nonspecific and are often absent unless symptoms and signs of renal failure develop.