Acute Tubular Necrosis

Question 1

What is acute tubular necrosis?
What is it the most common cause of?
Is it reversible?

Answer 1

Damage and death of epithelial cells of renal tubules
I.e. non-inflammatory process, just structural damage

AKI

Reversible due to epithelial cells being able to regenerate
I.e. takes 7-21 days

Question 2

What can cause acute interstitial necrosis?

Answer 2

Hypotension due to:

• shock
• sepsis
• dehydration

Direct damage by toxins: (nephrotoxins)

• Radiological contrast dye
• Gentamycin
• NSAIDs

Question 3

What is the pathognomonic finding on urinalysis?

What else can be present?

Answer 3

Muddy brown casts = indicative of epithelial cell necrosis

Question 4

How is acute tubular necrosis managed?

Answer 4

(SAME AS AKI)

Supportive managment
IV fluids
Stop nephrotoxic medications
Treat the complications