Loading icon
Press enter or spacebar to select a desired language.
Health Information Center

Acute Tubular Necrosis

  • Amy Scholten, MPH
Publication Type:


Acute Tubular Necrosis


Acute tubular necrosis (ATN) is an injury to the tiny tube-shaped cells in the kidneys. ATN can lead to more serious kidney problems.

Anatomy of the Kidney.

Glomerulonephritishttp://services.epnet.com/getimage.aspx?imageiid=81388138Glomerulonephritis_New.jpgGlomerulonephritisNULLjpgGlomerulonephritisNULL\\hgfiler1\intellect\images\Glomerulonephritis_New.jpgNULL72NULL2010-10-113064268138_179628Copyright © Nucleus Medical Media, Inc.


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


ATN may cause:

  • Urinating (peeing) more or less than normal
  • Confusion
  • Tiredness
  • Lack of hunger
  • Nausea and vomiting
  • Weight gain
  • Swelling


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.


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


The risk may be lowered by managing health problems that can harm the kidneys.





  • 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.


  • Daniel A. Ostrovsky, MD
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.