Acute tubular necrosis

Question 1

what is it?

Answer 1

necrosis of epithelial cells of kidney tubules

Question 2

features?

Answer 2

• most common cause of AKI
• epithelial cells have ability to regenerate therefore it is reversible
• takes 7-21 days to recover

Question 3

aetiology?

Answer 3

• ischaemia due to hypoperfusion
  
  • dehydration
  • shock
  • sepsis
• toxins
  
  • radiology contrast dye
  • gentamicin
  • NSAIDs
  • lithium
  • heroin

Question 4

Ix?

Answer 4

Urinalysis

• muddy brown casts –> pathagnomonic

Question 5

Mx?

Answer 5

• supportive management
• fluid rehydration
• stop nephrotoxic drugs
• treat complications