Acute tubular necrosis

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Kidney anatomy

Kidney - blood and urine flow

Acute tubular necrosis is a kidney disorder involving damage to the renal tubule cells, resulting in acute kidney failure.

Necrosis - renal tubular; ATN; Necrosis - acute tubular

Acute tubular necrosis (ATN) is caused by ischemia of the kidneys (lack of oxygen to the kidney tissues), or by exposure to materials that are poisonous to the kidney (nephrotoxic agents).

The internal structures of the kidney, particularly the tissues of the kidney tubule, become damaged or destroyed. ATN is one of the most common structural changes associated with the development of acute renal failure.

ATN, along with prerenal azotemia are the most common causes of renal failure in hospitalized patients. Risks for acute tubular necrosis include injury or trauma with resulting damage to the muscles, recent major surgery, blood transfusion reaction, septic shock or other forms of shock, and severe hypotension (low blood pressure) that lasts longer than 30 minutes.

Any condition that causes a reduction in the amount of blood being pumped by the heart may cause ATN. Liver disease and damage caused by diabetes (diabetic nephropathy) may make a person more susceptible to the condition.

ATN can be caused by:

• Exposure to nephrotoxic agents such as aminoglycoside antibiotics
• Antifungal agents such as amphotericin
• Dye used for radiographic (x-ray) studies

Review Date: 12/09/2005
Reviewed By: Colm C. Magee, MD, MPH, Medical Director, Renal Transplant, Brigham & Women's Hospital, and Assistant Professor, Harvard Medical School, Boston, MA. Review provided by VeriMed Healthcare Network.