Definition

Acute tubular necrosis (ATN) is an injury to the tiny tube-shaped cells in the kidneys. ATN can lead to more serious kidney problems.

Anatomy of the Kidney

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Causes

ATN may be caused by:

• Lack of blood flow and oxygen to the kidneys from:
  • Blood clots
  • Blood loss
  • Loss of fluids from dehydration
  • Problems from surgery
• Damage to kidney cells from things like medicines, contrast material used in imaging, and certain drugs

Risk Factors

Things that may raise the risk of this problem are:

• Taking certain medicines
• Using certain illegal drugs
• Having certain health problems, such as:
  • Kidney, heart, liver, or lung disease
  • Blood pressure that is too high or low
  • Diabetes
  • Cancer
• Blood loss from surgery

Symptoms

ATN may cause:

• Urinating more or less than normal
• Confusion
• Tiredness
• Lack of hunger
• Nausea and vomiting
• Weight gain
• Swelling

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done.

Blood and urine tests will be done to look for problems with how the kidneys are working. Other tests will be done to find a cause. You may need to see a doctor who treats kidney diseases.

Treatment

Care depends on what is causing the problem. Options are:

• Supportive care, such as fluids, nutrition, and oxygen
• Stopping or changing medicines that are harming the kidneys
• Medicines to:
  • Control health problems that are causing ATN
  • Manage problems caused by ATN, such as swelling, nausea, or feeling tired
• Dialysis to filter blood when the kidneys cannot

Prevention

The risk may be lowered by managing health problems that can harm the kidneys.