Acute tubular necrosis: Difference between revisions

Jump to navigation Jump to search
WikiBot (talk | contribs)
m Robot: Automated text replacement (-\<youtube v=(.+)\/\> +{{#ev:youtube|\1}})
Kalsang Dolma (talk | contribs)
No edit summary
Line 13: Line 13:
   MeshID        = D007683 |
   MeshID        = D007683 |
}}
}}
{{SI}}
{{Acute tubular necrosis}}
{{CMG}}
{{CMG}} '''Associate Editor-In-Chief:''' {{CZ}}


'''Associate Editor-In-Chief:''' {{CZ}}
{{SK}} ATN




Line 22: Line 22:
==Overview==
==Overview==


'''Acute tubular necrosis''' or ('''ATN''') is a medical condition involving the death of tubular cells that form the [[tubule]] that transports [[urine]] to the [[ureter]]s while reabsorbing 99% of the water (and highly concentrating the salts and metabolic byproducts).  Tubular cells continually replace themselves and if the cause of Acute Tubular Necrosis is removed then recovery is likely. ATN presents with [[acute renal failure]] and is one of the most common causes of ARF.  The presence of "muddy brown casts" of epithelial cells found in the urine during urinalysis is pathognomonic for Acute Tubular Necrosis.
'''Acute tubular necrosis''' is a medical condition involving the death of tubular cells that form the [[tubule]] that transports [[urine]] to the [[ureter]]s while reabsorbing 99% of the water (and highly concentrating the salts and metabolic byproducts).  Tubular cells continually replace themselves and if the cause of Acute Tubular Necrosis is removed then recovery is likely. ATN presents with [[acute renal failure]] and is one of the most common causes of ARF.  The presence of "muddy brown casts" of epithelial cells found in the urine during urinalysis is pathognomonic for Acute Tubular Necrosis.


It may be classified as either ''toxic'' or ''[[Ischemia|ischemic]]''. Toxic Acute Tubular Necrosis occurs when the tubular cells are exposed to a toxic substance ([[nephrotoxic]] Acute Tubular Necrosis). Ischemic Acute Tubular Necrosis occurs when the tubular cells do not get enough oxygen, a condition they are highly sensitive to due to their very high [[metabolism]].
It may be classified as either ''toxic'' or ''[[Ischemia|ischemic]]''. Toxic Acute Tubular Necrosis occurs when the tubular cells are exposed to a toxic substance ([[nephrotoxic]] Acute Tubular Necrosis). Ischemic Acute Tubular Necrosis occurs when the tubular cells do not get enough oxygen, a condition they are highly sensitive to due to their very high [[metabolism]].
Line 46: Line 46:


{{Nephrology}}
{{Nephrology}}


[[Category:Nephrology]]
[[Category:Nephrology]]
[[Category:Disease]]


{{WikiDoc Help Menu}}
{{WikiDoc Help Menu}}
{{WS}}
{{WS}}

Revision as of 19:25, 28 September 2012

For patient information click here

Acute tubular necrosis
Acute Tubular Necrosis: Gross, good example of bilateral cortical necrosis and uterus with hemorrhage (secondary to abortion).
Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology
ICD-10 N17.0
ICD-9 584.5
DiseasesDB 11263
MeSH D007683

Acute tubular necrosis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Acute tubular necrosis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Acute tubular necrosis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Acute tubular necrosis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Acute tubular necrosis

CDC on Acute tubular necrosis

Acute tubular necrosis in the news

Blogs on Acute tubular necrosis

Directions to Hospitals Treating Acute tubular necrosis

Risk calculators and risk factors for Acute tubular necrosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Synonyms and keywords: ATN


Overview

Acute tubular necrosis is a medical condition involving the death of tubular cells that form the tubule that transports urine to the ureters while reabsorbing 99% of the water (and highly concentrating the salts and metabolic byproducts). Tubular cells continually replace themselves and if the cause of Acute Tubular Necrosis is removed then recovery is likely. ATN presents with acute renal failure and is one of the most common causes of ARF. The presence of "muddy brown casts" of epithelial cells found in the urine during urinalysis is pathognomonic for Acute Tubular Necrosis.

It may be classified as either toxic or ischemic. Toxic Acute Tubular Necrosis occurs when the tubular cells are exposed to a toxic substance (nephrotoxic Acute Tubular Necrosis). Ischemic Acute Tubular Necrosis occurs when the tubular cells do not get enough oxygen, a condition they are highly sensitive to due to their very high metabolism.

Toxic Acute Tubular Necrosis

Toxic ATN can be caused by free hemoglobin or myoglobin, by medication such as antibiotics and cytostatic drugs, or by intoxication (ethylene glycol, "anti-freeze").

Histopathology: Toxic ATN is characterized by proximal tubular epithelium necrosis (no nuclei, intense eosinophilic homogeneous cytoplasm, but preserved shape) due to a toxic substance (poisons, organic solvents, drugs, heavy metals). Necrotic cells fall into the tubule lumen, obliterating it, and determining acute renal failure. Basement membrane is intact, so the tubular epithelium regeneration is possible. Glomeruli are not affected.

Ischemic Acute Tubular Necrosis

Ischemic Acute Tubular Necrosis can be caused when the kidneys are not sufficiently perfused for a long period of time (i.e. renal artery stenosis) or during shock. Hypoperfusion can also be caused by embolism of the renal arteries. Ischemic Acute Tubular Necrosis specifically causes skip lesions through the tubules.

Pathology

Acute tubular necrosis from ethylene glycol

{{#ev:youtube|mqXx2EMTgec}}

External links

Atlas of Pathology

Acute Tubular Necrosis

Template:Nephrology


Template:WS