Acute tubular necrosis causes: Difference between revisions
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==Causes== | ==Causes== | ||
===Ischemic Acute Tubular Necrosis=== | ===Ischemic Acute Tubular Necrosis=== | ||
Renal hypoperfusion is the major cause of ischemic ATN. A decrease in perfusion pressure to the extent that renal protective mechanisms fail to maintain adequate tissue perfusion leads to ATP depletion and cell necrosis. In parallel, disruption of renal protective mechanisms may also lead to ATN. Some etiologies associated with ischemic ATN include: | Renal hypoperfusion is the major cause of ischemic ATN. A decrease in perfusion pressure to the extent that renal protective mechanisms fail to maintain adequate tissue perfusion leads to ATP depletion and cell necrosis. In parallel, disruption of renal protective mechanisms may also lead to ATN. Some etiologies associated with ischemic ATN include:<ref name="pmid1288251">{{cite journal |vauthors=Kadiri S, Ogunlesi A, Osinfade K, Akinkugbe OO |title=The causes and course of acute tubular necrosis in Nigerians |journal=Afr J Med Med Sci |volume=21 |issue=1 |pages=91–6 |date=October 1992 |pmid=1288251 |doi= |url=}}</ref> | ||
* Hypotension | * Hypotension | ||
* Sepsis | * Sepsis | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Overview
Causes
Ischemic Acute Tubular Necrosis
Renal hypoperfusion is the major cause of ischemic ATN. A decrease in perfusion pressure to the extent that renal protective mechanisms fail to maintain adequate tissue perfusion leads to ATP depletion and cell necrosis. In parallel, disruption of renal protective mechanisms may also lead to ATN. Some etiologies associated with ischemic ATN include:[1]
- Hypotension
- Sepsis
- Cardiogenic shock
- Renal vein thrombosis
- ACE inhibitors
- Angiotensin receptor blockers
- NSAIDs
- IV contrast
Toxic Acute Tubular Necrosis
ATN can occur due to direct or indirect tubular cell cytotoxicity secondary to medications or substance exposures. Some causes of toxic ATN include:
- Myoglobinuria
- Aminoglycosides[2]
- Cephalothin[3]
- Bisphosphonates[4]
- Cisplatin[5]
- Tenofovir[6]
- Amphotericin B[7]
- Lithium[7]
- Mannitol[7]
- Foscarnet[7]
- Cocaine[7]
- Pentamidine[7]
- Sucrose[7]
- Streptozocin[7]
References
- ↑ Kadiri S, Ogunlesi A, Osinfade K, Akinkugbe OO (October 1992). "The causes and course of acute tubular necrosis in Nigerians". Afr J Med Med Sci. 21 (1): 91–6. PMID 1288251.
- ↑ Erdem A, Gündoğan NU, Usubütün A, Kilinç K, Erdem SR, Kara A; et al. (2000). "The protective effect of taurine against gentamicin-induced acute tubular necrosis in rats". Nephrol Dial Transplant. 15 (8): 1175–82. PMID 10910441.
- ↑ Bobrow SN, Jaffe E, Young RC (1972). "Anuria and acute tubular necrosis associated with gentamicin and cephalothin". JAMA. 222 (12): 1546–7. PMID 4678426.
- ↑ Banerjee D, Asif A, Striker L, Preston RA, Bourgoignie JJ, Roth D (2003). "Short-term, high-dose pamidronate-induced acute tubular necrosis: the postulated mechanisms of bisphosphonate nephrotoxicity". Am J Kidney Dis. 41 (5): E18. PMID 12778436.
- ↑ Faubel S, Ljubanovic D, Reznikov L, Somerset H, Dinarello CA, Edelstein CL (2004). "Caspase-1-deficient mice are protected against cisplatin-induced apoptosis and acute tubular necrosis". Kidney Int. 66 (6): 2202–13. doi:10.1111/j.1523-1755.2004.66010.x. PMID 15569309 Check
|pmid=value (help). - ↑ Herlitz LC, Mohan S, Stokes MB, Radhakrishnan J, D'Agati VD, Markowitz GS (2010). "Tenofovir nephrotoxicity: acute tubular necrosis with distinctive clinical, pathological, and mitochondrial abnormalities". Kidney Int. 78 (11): 1171–7. doi:10.1038/ki.2010.318. PMID 20811330.
- ↑ 7.0 7.1 7.2 7.3 7.4 7.5 7.6 7.7 Guo X, Nzerue C (2002). "How to prevent, recognize, and treat drug-induced nephrotoxicity". Cleve Clin J Med. 69 (4): 289–90, 293–4, 296-7 passim. PMID 11996200.