What is the pathophysiology of acute tubular necrosis?

Acute tubular necrosis (ATN) is a kidney disorder involving damage to the tubule cells of the kidneys, which can lead to acute kidney failure. The tubules are tiny ducts in the kidneys that help filter the blood when it passes through the kidneys.

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What is difference between AKI and ATN?

Acute tubular necrosis (ATN) is the most common cause of acute kidney injury (AKI) in the renal category (that is, AKI in which the pathology lies within the kidney itself). The term ATN is actually a misnomer, as there is minimal cell necrosis and the damage is not limited to tubules.

What are the 2 types of ATN?

Types

ischemic ATN occurs when severe hypotension leads to decreased renal perfusion.
toxic ATN occurs when a nephrotoxic drug decreases renal perfusion and/or causes tubular injury.

What are the clinical indicators for ATN?

Common Clinical Indicators for Acute Tubular Necrosis:

Prolonged reduced renal blood flow (ischemic ATN)
Exposures to nephrotoxins and medications such as gentamycin, vancomycin, cyclosporine, tacrolimus, ace inhibitors, ARBS, cisplatin.
Oliguric or on-oliguric.
May require dialysis.

How is ATN diagnosed?

Acute tubular necrosis is usually diagnosed by a nephrologist (kidney specialist). The diagnosis is mainly clinical but can be guided by microscopic examination of your urine. A biopsy of the kidney tissue can be done in certain cases, especially when the diagnosis is uncertain.

What is ischemic ATN?

ATN may be classified as either toxic or ischemic. Toxic ATN occurs when the tubular cells are exposed to a toxic substance (nephrotoxic ATN). 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.

What is the criteria for ATN?

Acute tubular necrosis is suspected when serum creatinine rises ≥ 0.3 mg/dL/day (26.5 micromol/liter [μmol/L]) above baseline or a 1.5- to 2.0-fold increase in serum creatinine from baseline after an apparent trigger (eg, hypotensive event, exposure to a nephrotoxin); the rise in creatinine may occur 1 to 2 days after …

Which patient is most likely to develop ATN?

Diagnosis is based on a progressive rise in serum creatinine 24 to 48 hours… read more )…Acute tubular necrosis is more likely to develop in patients with the following:

Preexisting chronic kidney disease.
Diabetes mellitus.
Preexisting hypovolemia or poor renal perfusion.
Older age.

What are the markers of acute tubular necrosis (ATN)?

Other markers include urinary alpha one microglobulin, beta-2 microglobulin, urinary liver-type fatty acid-binding protein (L-FABP), and kidney injury molecule 1 (KIM-1) for the detection of proximal tubular damage, urinary interleukin-18 (IL-18) is known to differentiate ATN from CKD, urinary tract infection (UTI), and prerenal azotemia.

What is the main cause of ATN?

Causes of ATNCauses of ATN ATN is usually caused by an acute event,ATN is usually caused by an acute event, either ischemic or toxic.either ischemic or toxic. 16.

What is acute renal tubular necrosis (Aki)?

Acute Renal Tubular Necrosis – StatPearls – NCBI Bookshelf The most common cause of acute kidney injury (AKI) is acute tubular necrosis (ATN) when the pattern of injury lies within the kidney (intrinsic disease).

What is the prognosis of acute tubular necrosis (ATN)?

The mortality in patients with acute tubular necrosis depends on the underlying condition that leads to acute tubular necrosis. Some factors that lead to poor survival in such patients include oliguria, poor nutritional status, male gender, the need for mechanical ventilation, stroke, seizures, and acute myocardial infarction.