Describe the pathophysiology of acute tubular necrosis (ATN)

Question 1

Initiation phase

Answer 1

o Kidney injury is evolving
o Injury is reversible at this point
o Reduced perfusion
o Prevention of injury is possible

Question 2

Maintenance phase

Answer 2

o Established kidney injury and dysfunction
o Kidney injury has happened, can be weeks to months
o Urine output is lowest (oliguria) during this phase and serum creatinine (CR) and blood urea nitrogen (BUN) both increase

Question 3

Recovery phase

Answer 3

o Injury repaired and normal renal function reestablished
o Diuresis common
o Decline in serum creatinine and urea
o Increase in creatinine clearance