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Acute tubular necrosis
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Acute tubular necrosis is injury to and death of the cells that make up the kidney's tubules, the thin ducts that carry the fluid that will become urine. It is the most common cause of acute kidney injury, which is when the kidney stops working properly within hours or days.
It develops by two routes, and sometimes by both at once. One is ischemia, meaning loss of blood supply: the vessels inside the kidney clamp down and the cells are left without blood. The other is nephrotoxic injury: a drug poisons those cells directly. The same tube can be ruined by losing its blood supply or by what passes through it.
When the cells die, the kidney filters less. The glomerular filtration rate, which is the amount of blood the kidney cleans each minute, drops sharply, and creatinine and blood urea nitrogen, two waste products that are normally cleared, rise in the blood. Watch out for this: those numbers rise late, after the tubule has already been damaged.
In brief
Acute tubular necrosis, the most common cause of acute kidney injury, is a pattern of injury and death of kidney cells.
It results from an ischemic event, a nephrotoxic mechanism, or both, through vasoconstriction within the kidney or direct drug toxicity.
The same tube can be ruined by losing its blood supply or by what passes through it.
The glomerular filtration rate falls and creatinine and blood urea nitrogen rise, although that rise lags behind the tubular injury.
Sources (1)
- National Center for Biotechnology Information, StatPearls PublishingAcute Renal Tubular Necrosis, StatPearlsPublished
This page explains the topic in general terms; it does not tell anyone what treatment to follow.
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