Acute Tubular Necrosis
Condition
Definition
Acute tubular necrosis (ATN) is an injury to the tiny tube-shaped cells in the kidneys. ATN can lead to more serious kidney problems.
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Causes
ATN may be caused by:
- Lack of blood flow and oxygen to the kidneys from:
- Blood clots
- Blood loss
- Loss of fluids from dehydration
- Problems from surgery
- Damage to kidney cells from things like medicines, contrast material used in imaging, and certain drugs
Risk Factors
Things that may raise the risk of this problem are:
- Taking certain medicines
- Using certain illegal drugs
- Having certain health problems, such as:
- Kidney, heart, liver, or lung disease
- Blood pressure that is too high or low
- Diabetes
- Cancer
- Blood loss from surgery
Symptoms
ATN may cause:
- Urinating (peeing) more or less than normal
- Confusion
- Tiredness
- Lack of hunger
- Nausea and vomiting
- Weight gain
- Swelling
Diagnosis
The doctor will ask about symptoms and past health. A physical exam will be done.
Blood and urine tests will be done to look for problems with how the kidneys are working. Other tests will be done to find a cause. The person will need to see a doctor who treats kidney diseases.
Treatment
Care depends on what is causing the problem. Options are:
- Supportive care, such as fluids, nutrition, and oxygen
- Stopping or changing medicines that are harming the kidneys
- Medicines to:
- Control health problems that are causing ATN
- Manage problems caused by ATN, such as swelling, nausea, or feeling tired
- Dialysis to filter blood when the kidneys cannot
Prevention
The risk may be lowered by managing health problems that can harm the kidneys.
National Institute of Diabetes and Digestive and Kidney Diseases
National Kidney Foundation
CANADIAN RESOURCES:
Health Canada
The Kidney Foundation of Canada
National Institute of Diabetes and Digestive and Kidney Diseases
National Kidney Foundation
CANADIAN RESOURCES:
Health Canada
The Kidney Foundation of Canada
References
- Acute tubular necrosis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/acute-tubular-necrosis.
- Acute tubular necrosis (ATN). Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/genitourinary-disorders/tubulointerstitial-diseases/acute-tubular-necrosis-atn.
- Levey, A , James, M. Acute kidney injury. Ann Intern Med. 2017 Nov 7;167(9):ITC66-ITC80.
Contributors
- Daniel A. Ostrovsky, MD
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