Acute Tubular Necrosis


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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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


ATN may cause:

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


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.


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


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


National Institute of Diabetes and Digestive and Kidney Diseases
National Kidney Foundation


The Kidney Foundation of Canada


Acute tubular necrosis. EBSCO DynaMed website. Available at: Accessed December 29, 2020.
Acute tubular necrosis (ATN). Merck Manual Professional Version website. Available at: Accessed December 29, 2020.
Levey, A , James, M. Acute kidney injury. Ann Intern Med. 2017 Nov 7;167(9):ITC66-ITC80.
Last reviewed September 2020 by EBSCO Medical Review Board Adrienne Carmack, MD
Last Updated: 12/29/2020

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