What is acute tubular necrosis?
Inside your kidneys are small tube-shaped structures that remove salt, excess fluids, and waste products from your blood. When these tubules are damaged or destroyed, you develop acute tubular necrosis (ATN), a type of acute kidney injury. The damage may result in acute kidney failure.
The symptoms of ATN vary depending on its severity. You may:
- feel drowsy even during the day
- feel lethargic or physically drained
- be excessively thirsty or experience dehydration
- urinate very little or not at all
- retain fluid or experience swelling in your body
- have episodes of confusion
- experience nausea or vomiting
The most common cause of ATN is a lack of oxygen reaching the cells of your kidneys. If blood can’t reach your kidneys due to a blockage or decreased flow, your kidneys can be damaged or destroyed. This lack of blood flow can be caused by hypotension and certain drugs.
Harmful substances in your blood can also damage tubules. Toxins may change the way cells in the tubules function.
Certain chemicals and medications such as antibiotics, anesthetics, and radiology dyes may cause ATN if your body reacts negatively to them.
A number of factors may place you at risk for ATN. The risk factors depend on your overall health and any other medical issues such as:
- Recent injury to your body, especially the kidneys. The trauma may cause blood clots or another blockage in the blood vessels servicing your kidneys.
- A bad reaction to a blood transfusion. Your body may reject or destroy the blood cells in transfused blood. This may lead to problems if your body can’t get sufficient blood supply to the kidneys.
- Septic shock. Sepsis can cause a drastic drop in your blood pressure and slow blood circulation to your kidneys. This is very dangerous if you already have low blood pressure problems.
- A major surgical procedure. This can cause complications with your blood supply or circulation.
If your doctor suspects ATN, they may order specific diagnostic tests:
- urinalysis to look for abnormal cells in your urine, the color of the urine, and signs of infection from bacteria and other organisms
- blood urea nitrogen and creatinine urine tests since both levels increase with kidney failure
- biopsy to examine your kidney tissue
- blood tests to measure sodium and creatinine
- CT scans of the inside of your kidneys
Your doctor may prescribe medication to decrease the fluid and waste buildup in your kidneys. You may also be told to restrict your diet to reduce your intake of sodium and potassium.
It’s possible you’ll need to regulate the amount of water you drink to avoid excess fluid retention. Too much fluid can lead to abnormal swelling in your arms, legs, and feet.
Depending on your condition, dialysis could be another treatment option. This procedure helps your kidneys filter out excess fluids and waste.
Acute kidney failure can sometimes be reversible in people who are in otherwise good health.
The outlook is very good if you don’t have any underlying health conditions, and you were able to start treatment in the early stages of the condition.
If your ATN was caused by another condition, your recovery depends on your overall health.
To avoid ATN, treat conditions that decrease oxygen and blood flow to the kidneys. Control existing disorders such as diabetes, heart conditions, and liver disease. Drink plenty of water after using any contrast dyes. Ask your doctor to monitor your blood if you take medications that may be toxic to your kidneys.