Skip navigation | ||
|
||
Medical Encyclopedia |
|
Other encyclopedia topics: | A-Ag Ah-Ap Aq-Az B-Bk Bl-Bz C-Cg Ch-Co Cp-Cz D-Di Dj-Dz E-Ep Eq-Ez F G H-Hf Hg-Hz I-In Io-Iz J K L-Ln Lo-Lz M-Mf Mg-Mz N O P-Pl Pm-Pz Q R S-Sh Si-Sp Sq-Sz T-Tn To-Tz U V W X Y Z 0-9 |
Contents of this page: | |
|
|
Alternative names Return to top
Necrosis - renal tubular; ATN; Necrosis - acute tubularDefinition Return to top
Acute tubular necrosis is a kidney disorder involving damage to the renal tubule cells, resulting in acute kidney failure.Causes, incidence, and risk factors Return to top
Acute tubular necrosis (ATN) is caused by ischemia of the kidneys (lack of oxygen to the tissues), or by exposure to materials that are poisonous to the kidney (nephrotoxic agents).
The internal structures of the kidney, particularly the tissues of the kidney tubule, become damaged or destroyed. ATN is one of the most common structural changes associated with the development of acute renal failure.
ATN, along with prerenal azotemia are the most common causes of renal failure in hospitalized patients. Risks for acute tubular necrosis include injury or trauma with resulting damage to the muscles, recent major surgery, blood transfusion reaction, septic shock or other forms of shock, and severe hypotension (low blood pressure) that lasts longer than 30 minutes.
Any condition that causes a reduction in the amount of blood being pumped by the heart may cause ATN. Liver disease and damage caused by diabetes mellitus (diabetic nephropathy) may make a person more susceptible to the condition.
ATN can be caused by:
Symptoms Return to top
Signs and tests Return to top
Examination usually indicates acute renal failure. There may be signs of fluid overload, including abnormal sounds on listening to the heart and lungs with a stethoscope (auscultation).Treatment Return to top
In most people, acute tubular necrosis is a reversible lesion. The goal of treatment is to prevent life-threatening complications of acute renal failure during the time the lesion is present.
Treatment focuses on preventing the excess accumulation of fluids and wastes while allowing the kidneys to heal. Observation for deterioration of kidney function should be ongoing.
Fluid intake may be restricted to a volume equal to the volume of urine produced.
The intake of substances that are normally excreted by the kidney may be restricted to minimize their buildup in the body. This may include a diet high in carbohydrates, low in protein, reduced sodium, and reduced potassium.
The underlying cause must be identified and treated.
Diuretics may be used to increase the excretion of fluid from the kidney. Medications may be given to control potassium levels in the bloodstream.
Dialysis may be used to remove excess waste and fluids. This often makes the person feel better, and may make the kidney failure easier to control. Dialysis may not be necessary for all people, but is frequently lifesaving, particularly if serum potassium is dangerously high.
Decreased mental status, pericarditis, increased potassium levels, total lack of urine production, fluid overload, and uncontrolled accumulation of nitrogen waste products are common indications for dialysis.
Expectations (prognosis) Return to top
The duration of symptoms of ATN is variable. The decreased urine output phase may last from a few days to 6 weeks or more. This is occasionally followed by a period of high urine output, where the healed and newly refunctioning kidneys attempt to clear the body of fluid and wastes. One or two days after urine output rises, symptoms reduce and laboratory values begin to return to normal.Complications Return to top
Calling your health care provider Return to top
Call your health care provider if urine output decreases or stops, or if other symptoms suggestive of acute tubular necrosis develop.Prevention Return to top
Prompt treatment of conditions that can result in decreased blood flow and/or decreased oxygenation of the kidneys may reduce the risk of acute tubular necrosis.
Home | Health Topics | Drug Information | Encyclopedia | Dictionary | News | Directories | Other Resources | |
Copyright | Privacy | Accessibility | Selection Guidelines U.S. National Library of Medicine, 8600 Rockville Pike, Bethesda, MD 20894 National Institutes of Health | Department of Health & Human Services |
Page last updated: 28 October 2004 |