Acute Tubular Necrosis

Acute tubular necrosis is a condition that causes the lack of oxygen and blood flow to the kidneys, damaging them. Tube-shaped structures in the kidneys, called tubules, filter out waste products and fluid. These structures are damaged in acute tubular necrosis.

Causes of Acute Tubular Necrosis

  • The most frequent causes of acute tubular necrosis are a stroke or a heart attack, conditions that reduce oxygen to the kidneys.

  • Chemicals can also damage the tubules.

  • These include X-ray contrast dye, anesthesia drugs, antibiotics and other toxic chemicals.

Symptoms of Acute Tubular Necrosis

  • A small amount of urine output.

  • Swelling and fluid retention.

  • Nausea and vomiting.

  • Trouble waking up/drowsiness.

  • Feeling sluggish.

  • Confusion.

Diagnosis of Acute Tubular Necrosis

  • Several tests can be used to diagnose acute renal failure.

  • These include blood waste products such as blood urea nitrogen (BUN), creatinine and electrolyte levels such as plasma potassium.

  • The accumulation of these substances in the blood indicate that the kidneys are not working properly.

  • Acute tubular necrosis is usually diagnosed by a nephrologist (kidney specialist).

  • The diagnosis is mainly clinical but can be guided by microscopic examination of your urine.

  • A biopsy of the kidney tissue can be done in certain cases, especially when the diagnosis is uncertain.

Prevention of Acute Tubular Necrosis

  • Maintaining blood flow and oxygen to the kidneys can reduce the chance of developing acute tubular necrosis.

  • If a test with contrast dye is needed, drink a lot of water beforehand and afterwards.

  • Make sure your blood has been cross-matched before you receive a transfusion.

  • Work with your doctor to control the diseases that can damage the kidneys, such as high blood pressure, diabetes, liver disease and heart disease.

  • Avoid over-the-counter anti-inflammatory medications such as naproxen sodium and ibuprofen, especially if you have kidney disease.

Treatment of Acute Tubular Necrosis

  • Treating the underlying cause is crucial in order to allow the kidneys to recover.

  • While the kidneys can often self-heal, you may be required to follow some dietary restrictions that include limiting fluid, sodium and potassium intake.

  • This prevents the build-up of those substances while the kidneys are recovering.

  • Diuretics (drugs to increase urination) and potassium-controlling medications may be prescribed.

  • Dialysis may be needed until the kidneys improve

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