Acute Tubular Necrosis

Question 1

What is acute tubular necrosis?

Answer 1

Necrosis of the renal tubular epithelial cells affecting the functioning of the kidney.
It is the most common cause of AKI seen in clinical practice.

Question 2

What are the causes of acute tubular necrosis?

Answer 2

Ischaemia - shock, sepsis

Nephrotoxins - aminoglycosides, myoglobin secondary to rhabdomyolysis, radiocontrast agents, lead

Question 3

What are the features of acute tubular necrosis?

Answer 3

Features of AKI: raised urea, creatinine, potassium

Muddy brown casts in the urine

Question 4

What are the histopathological features of acute tubular necrosis?

Answer 4

Tubular epithelium necrosis: loss of nuclei and detachment of tubular cells from the basement membrane
Dilatation of the tubules may occur
Necrotic cells obstruct the tubule lumen

Question 5

What are the phases of acute tubular necrosis?

Answer 5

Oliguric phase
Polyuric phase
Recovery phase