Acute tubular necrosis

tubular necrosisischemic kidney failurekidney injurymuddy-brown castrenal tubular necrosis
Acute tubular necrosis (ATN) is a medical condition involving the death of tubular epithelial cells that form the renal tubules of the kidneys.wikipedia
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Clinical urine tests

urinalysisurine testurine sample
The presence of "muddy brown casts" of epithelial cells found in the urine during urinalysis is pathognomonic for ATN.
It is a useful parameter in acute kidney failure and oliguria, with a value below 1% indicating a prerenal disease and a value above 3% indicating acute tubular necrosis or other kidney damage.

Acute kidney injury

acute renal failureacute kidney failureuremic poisoning
ATN presents with acute kidney injury (AKI) and is one of the most common causes of AKI.
Common causes of each are glomerulonephritis, acute tubular necrosis (ATN), and acute interstitial nephritis (AIN), respectively.

Nephron

renal tubulenephronsrenal tubules
Acute tubular necrosis (ATN) is a medical condition involving the death of tubular epithelial cells that form the renal tubules of the kidneys.
Glomerular diseases include diabetic nephropathy, glomerulonephritis and IgA nephropathy; renal tubular diseases include acute tubular necrosis and polycystic kidney disease.

Urinary cast

urinary castscastsRBC casts
The presence of "muddy brown casts" of epithelial cells found in the urine during urinalysis is pathognomonic for ATN. Diagnosis is made by a FENa (fractional excretion of sodium) > 3% and presence of muddy casts (a type of granular cast) in urinalysis.
The "muddy brown cast" seen in acute tubular necrosis is a type of granular cast.

Pathognomonic

Characteristicdefinite histological proof of such infectiondiagnostic
The presence of "muddy brown casts" of epithelial cells found in the urine during urinalysis is pathognomonic for ATN.

Fractional excretion of sodium

fractional sodium excretionfractional excretion of Nafractional excretion of sodium (FENa)
Diagnosis is made by a FENa (fractional excretion of sodium) > 3% and presence of muddy casts (a type of granular cast) in urinalysis.
Higher values can suggest sodium wasting due to acute tubular necrosis or other causes of intrinsic kidney failure.

Statin

statinsHMG-CoA reductase inhibitorHMG-CoA reductase inhibitors
Toxic ATN can be caused by free hemoglobin or myoglobin, by medication including antibiotics such as aminoglycoside, statins such as atorvastatin, and cytotoxic drugs such as cisplatin, or by intoxication (ethylene glycol, "anti-freeze").
Rhabdomyolysis can in turn result in life-threatening kidney injury.

Renal cortical necrosis

The condition is "usually caused by significantly diminished arterial perfusion of the kidneys due to spasms of the feeding arteries, microvascular injury, or disseminated intravascular coagulation" and is the pathological progression of acute tubular necrosis.

Necrosis

necroticnecrotizingnecrotic tissue
Acute tubular necrosis (ATN) is a medical condition involving the death of tubular epithelial cells that form the renal tubules of the kidneys.

Epithelium

epithelialepithelial cellsepithelial cell
Acute tubular necrosis (ATN) is a medical condition involving the death of tubular epithelial cells that form the renal tubules of the kidneys.

Cell (biology)

cellcellscellular
Acute tubular necrosis (ATN) is a medical condition involving the death of tubular epithelial cells that form the renal tubules of the kidneys.

Hypotension

low blood pressurehypotensivelow
Common causes of ATN include low blood pressure and use of nephrotoxic drugs.

Nephrotoxicity

nephrotoxicnephrotoxinKidney damage
Common causes of ATN include low blood pressure and use of nephrotoxic drugs.

Intravenous therapy

intravenousintravenouslyinjection into a vein
Management relies on aggressive treatment of the factors that precipitated ATN (e.g. hydration and cessation of the offending drug).

Prognosis

prognosticprognosesprognostication
Because the tubular cells continually replace themselves, the overall prognosis for ATN is quite good if the underlying cause is corrected, and recovery is likely within 7 to 21 days.

Toxicity

toxicnon-toxicnontoxic
ATN may be classified as either toxic or ischemic.

Ischemia

ischemicischaemiaischaemic
ATN may be classified as either toxic or ischemic.

Metabolism

metabolicmetabolizedmetabolic pathways
Ischemic ATN occurs when the tubular cells do not get enough oxygen, a condition that they are highly sensitive and susceptible to, due to their very high metabolism.

Hemoglobin

haemoglobinoxyhemoglobindeoxyhemoglobin
Toxic ATN can be caused by free hemoglobin or myoglobin, by medication including antibiotics such as aminoglycoside, statins such as atorvastatin, and cytotoxic drugs such as cisplatin, or by intoxication (ethylene glycol, "anti-freeze").

Myoglobin

globular proteinsMB
Toxic ATN can be caused by free hemoglobin or myoglobin, by medication including antibiotics such as aminoglycoside, statins such as atorvastatin, and cytotoxic drugs such as cisplatin, or by intoxication (ethylene glycol, "anti-freeze").

Antibiotic

antibioticsantibacterialtopical antibiotic
Toxic ATN can be caused by free hemoglobin or myoglobin, by medication including antibiotics such as aminoglycoside, statins such as atorvastatin, and cytotoxic drugs such as cisplatin, or by intoxication (ethylene glycol, "anti-freeze").

Aminoglycoside

aminoglycosidesaminoglycoside antibioticaminoglycoside antibiotics
Toxic ATN can be caused by free hemoglobin or myoglobin, by medication including antibiotics such as aminoglycoside, statins such as atorvastatin, and cytotoxic drugs such as cisplatin, or by intoxication (ethylene glycol, "anti-freeze").

Atorvastatin

LipitorAtorvastatin Calciummodern drugs
Toxic ATN can be caused by free hemoglobin or myoglobin, by medication including antibiotics such as aminoglycoside, statins such as atorvastatin, and cytotoxic drugs such as cisplatin, or by intoxication (ethylene glycol, "anti-freeze").

Cytotoxicity

cytotoxiccytotoxincytotoxins
Toxic ATN can be caused by free hemoglobin or myoglobin, by medication including antibiotics such as aminoglycoside, statins such as atorvastatin, and cytotoxic drugs such as cisplatin, or by intoxication (ethylene glycol, "anti-freeze").

Cisplatin

Platinolcis''-PtCl 2 (NH 3 ) 2 cis-platinum
Toxic ATN can be caused by free hemoglobin or myoglobin, by medication including antibiotics such as aminoglycoside, statins such as atorvastatin, and cytotoxic drugs such as cisplatin, or by intoxication (ethylene glycol, "anti-freeze").