Acute tubular necrosis: Dx
Clinical - Renal/Urine/Electrolytes
Acute tubular necrosis (ATN) is a common diagnosis in acute renal failure, which is a rapidly progressing azotemia (increase in BUN/creatinine) that is often reversible. In order to effectively diagnose ATN, understanding the causes is helpful. There are many causes, but the following will be most encountered and associated with the practice of anesthesiology. ATN can be caused by ischemia, which can be encountered in hypovolemia or highly reduced mean arterial pressures. ATN might also be caused by direct renal tubular toxicity from contrast dyes, certain drugs, myoglobinuria, and hemoglobinuria (blood transfusion reaction).
Kumar, Vinay, MBBS, Abul K. Abbas, MBBS, Nelson Fausto, MD, and Jon C. Aster, MD PhD. “The Kidney.” Robbins and Cotran Pathologic Basis of Disease. Philadelphia, PA: Saunders/Elsevier, 2010. 906-38. Print.
See also Postoperative ATN: Differential diagnosis