Acute tubular necrosis classification
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chandrakala Yannam, MD [2]
Overview
Acute tubular necrosis may be classified based on mechanisms of tubular injury into three categories including ischemic, toxin-induced, and mixed.
Classification
- Acute tubular necrosis may be classified into three categories based on the mechanisms of tubular injury involved.[1]
- Ischemic acute tubular necrosis
- Nephrotoxic acute tubular necrosis
- Mixed acute tubular necrosis
- Ischemic ATN resulting from conditions leading to inadequate blood flow and oxygenation to the kidneys during 48 hrs (eg, shock, sepsis, hemorrhage, volume loss, and hypotension) without nephrotoxin exposure that results in acute renal failure and rise in serum creatinine levels.
- Nephrotoxic ATN occurs as a result of exposure of kidneys to various nephrotoxic medications and chemicals (eg, aminoglycosides, radiocontrast media, ACE inhibitors, NSAIDs, cyclosporine, and sulfa drugs) during 72 hrs preceding the increase in serum creatinine.
References
- ↑ Santos WJ, Zanetta DM, Pires AC, Lobo SM, Lima EQ, Burdmann EA (2006). "Patients with ischaemic, mixed and nephrotoxic acute tubular necrosis in the intensive care unit--a homogeneous population?". Crit Care. 10 (2): R68. doi:10.1186/cc4904. PMC 1550879. PMID 16646986.