ACUTE TUBULAR NECROSIS

SUMMARY

1. ATN is caused by ischemia (abrupt decrease in renal perfusion) or a nephrotoxin.

2. Nephrotoxic ATN has endogenous and exogenous causes:

• Endogenous - free myoglobin (rhabdomyolysis), free hemoglobin (intravascular hemolysis)

• Exogenous - contrast-related, drugs (aminoglycosides, amphotericin B, foscamet), osmotic nephropathy-IVIG with sucrose/mannitol/dextran, especially in patients with underlying chronic kidney disease, acute phosphate nephropathy, use of bowel purgatives containing sodium phosphate

Reference(s)

Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].