Acute Tubular Necrosis

Acute tubular necrosis (ATN) is the most common underlying cause of acute renal failure, in which kidney function diminishes suddenly and significantly.

Causes

The condition involves damage to, and the consequent death of, tubule cells of the kidney, usually due to insufficient oxygen supply via the bloodstream. In some other cases, it happens when tissues in the kidney are exposed to toxic or damaging substances.

Risk factors for ATN include:

·         Immune system’s rejection of transplanted blood;

·         Muscle damage due to trauma or injury;

·         Low blood pressure over a period of 30 minutes or more;

·         Presence of infectious bacteria in the blood; and

·         Major surgery.

Compromised liver and kidney function due to diabetes can also render an individual more vulnerable to ATN.

Symptoms and diagnosis

The symptoms of ATN include:

·         Considerably decreased, or no, urine output;

·         Fluid retention and bloating;

·         Nausea;

·         Vomiting; and

·         Depressed consciousness or coma.

Upon physical examination, a stethoscope may detect unusual sounds from the heart and lung, resulting from an excess of fluid in the body. Urinalysis can also be used to corroborate the diagnosis.

Treatment

In most cases, ATN is a reversible condition. Treatment is aimed at preventing life-threatening complications associated with acute renal failure.

Fluid ingested by the patient are usually restricted to match the volume of urine passed, preventing the further build-up of fluid in the kidneys, therefore allowing it to rest.

Medications may be administered orally or via a drip (intravenously) to promote the removal of fluid from the body. Temporary dialysis can also be done.