Acute Tubular Necrosis

Question 1

Name 5 complications of ATN.

Answer 1

1. Metabolic acidosis
2. Hypocalcaemia
3. Hyperphosphotaemia
4. Hypoalbuminaemia
5. Hyperkalaemia

Question 2

Name 4 areas of volume loss that may result in ischaemia leading to ATN.

Answer 2

1. Renal loss
2. GI loss
3. Haemorrhage (e.g post surgery)
4. Skin loss

Question 3

Name 3 endogenous toxins which can cause ATN.

Answer 3

1. Haemoglobin
2. Myoglobin
3. Endotoxins (bacteria)

Question 4

Name 6 types of exogenous toxins which can cause ATN.

Answer 4

1. Antibiotics
2. Antivirals
3. Antineoplastics
4. Contrast media
5. Heavy metals
6. Other

Question 5

Name 2 families of antibiotics which can cause ATN.

Answer 5

1. Aminoglycasides

2. Cephalosporins

Question 6

What findings will there be in the urine of a patient with ATN? Name 2.

Answer 6

1. Pigmented granular casts

2. High sodium

Question 7

How does ATN usually present?

Answer 7

Increase in levels of urea and creatinine in the blood after a trigger (hypotensive episode, sepsis, rhabdomyolysis, or nephrotoxic drug administration) as well as a reduction GFR.