Acute Tubular Necrosis Flashcards
1
Q
Define + causes
A
Ischemia or injury to epithelial cells of renal tubule, due to hypoperfusion e.g. from sepsis/surgery or injury from contrast dye, gentamycin
2
Q
Presentation - specifically in urinalysis
A
NV
Oliguria/anuria
Hypotension
Tachycardia
Urinalysis - muddy brown cast cells / epithelial cells
Note also: oedema (sign of circulatory collapse) thirst dizziness orthopnoea if HF leading to ATN
3
Q
Signs
A
AKI - raised creatinine, low GFR
4
Q
Complications
A
Can actually recover
5
Q
Rx factors
A
Old age CKD DM Nephrotoxic agents Surgery Endogenous toxic exposure
6
Q
Examples of endogenous toxins
A
Rhabdomyolysis Haemolysis Myeloma Bacteria Hyperuricemia (e.g. from gout or tumour lysis syndrome)
7
Q
Investigations - bloods
A
U and E Urine sodium, osmolality Coag studies as ATN can cause uremic toxins to affect platelets, and therefore cause bleeding Urinalysis Urinary myoglobin
8
Q
Investigations - other
A
ECG if hyperkalemia
ABG for metabolic acidosis
USS of kidneys
Biopsy of kidneys
9
Q
Management
A
Supportive care - fluids
Haemodialysis
