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Inside your kidneys are small tube-shaped structures that remove salt, excess fluids, and waste products from the blood. When these tubules are damaged or destroyed, you develop acute tubular necrosis (ATN). The damage may result in acute kidney failure.
The most common cause of ATN is a lack of oxygen. When blood can not reach the tissues and cells of the kidneys due to a blockage or restriction, the kidneys can be damaged or destroyed.
Harmful substances in the blood can also damage tubules. Toxins may change the way cells in the tubules function.
Certain chemicals and medications (such as antibiotics), anesthetics, and radiology dyes may cause ATN if your body reacts negatively to them.
A number of factors may place you at risk for ATN. The risk factors depend on your overall health and any other medical issues such as:
The trauma may cause blood clots or another blockage to occur in the blood vessels servicing your kidneys.
Your body may reject or destroy the blood cells in transfused blood. This may lead to problems if your body cannot get sufficient blood supply to the kidneys.
Septic shock may cause a drastic drop in your body’s blood pressure and slow blood circulation to the kidneys. This is very dangerous if you already have low blood pressure problems.
The surgery may cause complications with your blood supply or circulation.
The symptoms of ATN may vary depending on its severity. You may:
If your doctor suspects acute tubular necrosis, he or she may order specific diagnostic tests. These testing procedures include:
Your doctor may prescribe medication to decrease the fluid and waste buildup in your kidneys. You may also be told to restrict your diet to reduce the amount of sodium and potassium in your body. You may also need to regulate the amount of water you drink to avoid excessive fluid retention. Too much fluid can lead to abnormal swelling (edema) in your arms, legs, and feet. As a last resort, you may temporarily need dialysis to help your kidneys filter out excess fluids and wastes.
You may see a decrease in urine output for up to six weeks. It may increase after that before returning to normal.
To avoid ATN, treat conditions that decrease oxygen and blood flow to the kidneys. Control existing conditions such as diabetes, heart disorders and liver disease. Drink plenty of water after using any contrast dyes. Ask your doctor to monitor your blood if you take medications that may be toxic to the kidneys.
Written by: Brindles Lee Macon and Winnie Yu
Medically reviewed by George Krucik, MD
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