Caused by ischemic or nephrotoxic injury to renal tubular epithelial cells, which results in cell death or detachment from basement membrane.
A history of hypotension, fluid depletion, or exposure to nephrotoxic agents is usually present.
In otherwise healthy individuals, when the underlying insult is corrected, the patient frequently has a good outcome with complete renal recovery.
There is no specific therapy for acute tubular necrosis apart from supportive care.
Reversible or irreversible type of renal failure caused by ischemic or toxic injury to the renal tubular epithelial cells. The injury results in cell death or detachment from basement membrane causing tubular dysfunction.
History and exam
- underlying renal disease
- low renal perfusion
- diabetes mellitus
- excessive fluid loss
- major surgery
- cardiac arrest
- mechanical ventilation
- exposure to nephrotoxins
- exposure to radiocontrast media
- muscle trauma
- advanced age
- multiple myeloma
- basic metabolic profile (including BUN and creatinine)
- BUN-to-creatinine ratio
- urine sodium concentration
- urine osmolality
- fractional excretion of sodium
- fractional excretion of chloride
- urinalysis for sediment
- coagulation studies
- urinary myoglobin
MJLL lectured for Abbvie and Sanofi sponsored scientific events and has links with Vifor Fresenius Medical Care Renal Pharma.
Dr Maria Jesus Lloret Cora would like to gratefully acknowledge Dr Roser Torra, the previous contributor to this monograph. RT declares that she has no competing interests.
AK has received a fee for speaking about perioperative blood management from Ortho-Biotech and has also received reimbursement from medscape.com for the education webcast of the same presentation.
Chicago Medical School
Rosalind Franklin University
IM declares that he has no competing interests.
Department of Family Medicine
University of Texas Health Science Center
RT declares that he has no competing interests.
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