Acute tubular necrosis

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Kidney anatomy

Kidney - blood and urine flow

Necrosis - renal tubular; ATN; Necrosis - acute tubular

• Urine output, decreased or none
• Generalized swelling, fluid retention
• Nausea, vomiting
• Decreased consciousness
  • Drowsy, lethargic, hard to arouse
  • Delirium or confusion
  • Coma

Note: Other symptoms of acute renal failure may also be present.

Examination usually indicates acute renal failure. There may be signs of fluid overload, including abnormal sounds on listening to the heart and lungs with a stethoscope (auscultation).

• Urinalysis may show casts , renal tubular cells, and red blood cells.
• Urine sodium may be high.
• Fractional excretion of sodium and of urea may be relatively high.
• Urine specific gravity and osmolarity urine indicate dilute urine
• BUN and serum creatinine levels may increase.

A kidney biopsy may show acute tubular necrosis, but a biopsy is rarely performed.

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.