Acute Tubular Necrosis

Acute Tubular Necrosis

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.

Anatomy of the Kidney

Glomerulonephritis
Copyright © Nucleus Medical Media, Inc.

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

Diagnosis

The doctor will ask about your symptoms and health history. 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. You may 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.

RESOURCES:

National Institute of Diabetes and Digestive and Kidney Diseases
https//www.niddk.nih.gov
National Kidney Foundation
https://www.kidney.org

CANADIAN RESOURCES:

The Kidney Foundation of Canada
https://www.kidney.ca

References:

Acute tubular necrosis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/acute-tubular-necrosis. Accessed December 29, 2020.
Acute tubular necrosis (ATN). Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/home/kidney-and-urinary-tract-disorders/kidney-filtering-disorders/acute-tubular-necrosis. Accessed December 29, 2020.
Levey, A , James, M. Acute kidney injury. Ann Intern Med. 2017 Nov 7;167(9):ITC66-ITC80.
Last reviewed September 2020 by EBSCO Medical Review Board Adrienne Carmack, MD
Last Updated: 12/29/2020

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