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Acute Kidney Tubular Necrosis

What is Acute Tubular Necrosis?

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.

What Are the Symptoms of Acute Tubular Necrosis?

The symptoms of ATN may vary depending on its severity. You may:

  • have problems waking up
  • feel drowsy even during the day
  • feel lethargic or physically drained
  • be excessively thirsty or experience dehydration
  • urinate very little or not at all
  • retain fluid or experience swelling in your body
  • have episodes of confusion
  • experience nausea or have the need to vomit

What Causes Acute Tubular Necrosis?

The most common cause of ATN is a lack of oxygen reaching the cells of the kidney. When blood cannot reach the tissues and cells of the kidneys due to a blockage or restriction, the kidneys can be damaged or destroyed.  A heart attack, stroke, and long-standing diabetes can result in reduced blood flow to the kidneys causing cell death and ATN.

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.

Who Is at Risk for Acute Tubular Necrosis?

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:

  • Recent injury to your body, especially the kidneys. The trauma may cause blood clots or another blockage to occur in the blood vessels servicing your kidneys.
  • A bad reaction to a blood transfusion. 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. This can 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.
  • A major surgical procedure. This can cause complications with your blood supply or circulation.

Diagnosing Acute Tubular Necrosis?

If your doctor suspects acute tubular necrosis, they may order specific diagnostic tests. These testing procedures include:

  • urinalysis to look for abnormal cells in your urine, the color of the urine, and signs of infection from bacteria and other organisms
  • blood urea nitrogen (BUN) to check for conditions such as kidney failure and disease
  • biopsy to examine the kidney tissue
  • blood tests to measure sodium and creatinine levels.
  • CT scans to take pictures of the inside of your kidneys.

Treating Acute Tubular Necrosis

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. You may temporarily need dialysis to help your kidneys filter out excess fluids and wastes.

What Is the Long Term Outlook for Acute Kidney Tubular Necrosis?

Your recovery time and long-term outlook will depend on many factors. Acute kidney failure can sometimes be reversible in people who are in otherwise good health.

The outlook is very good for people who don’t have any underlying health conditions, and who were able to start treatment in the early stages of the condition.

If your ATN was caused by another condition, your recovery depends on your overall health.

Preventing Acute Tubular Necrosis

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.

Content licensed from:

Written by: Brindles Lee Macon and Winnie Yu
Medically reviewed on: Jan 22, 2016: George Krucik, MD MBA

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
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