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Because necrosis is often not present, the term acute tubular injury (ATI) is preferred by pathologists over the older name acute tubular necrosis (ATN). [1] ATN presents with acute kidney injury (AKI) and is one of the most common causes of AKI. [2] Common causes of ATN include low blood pressure and use of nephrotoxic drugs. [2]
Renal cortical necrosis (RCN) is a rare cause of acute kidney failure. The condition is "usually caused by significantly diminished arterial perfusion of the kidneys due to spasms of the feeding arteries, microvascular injury, or disseminated intravascular coagulation " and is the pathological progression of acute tubular necrosis . [ 1 ]
Intrinsic renal causes of AKI include glomerulonephritis, lupus nephritis, acute tubular necrosis, certain antibiotics, and chemotherapeutic agents. [5] Postrenal causes of AKI include kidney stones , bladder cancer , neurogenic bladder , enlargement of the prostate , narrowing of the urethra , and certain medications like anticholinergics .
Low fractional excretion indicates sodium retention by the kidney, suggesting pathophysiology extrinsic to the urinary system such as volume depletion or decrease in effective circulating volume (e.g. low output heart failure). Higher values can suggest sodium wasting due to acute tubular necrosis or other
Renal azotemia (acute kidney failure) typically leads to uremia. It is an intrinsic disease of the kidney, generally the result of kidney parenchymal damage. Causes include kidney failure, glomerulonephritis, acute tubular necrosis, or other kidney disease. [3] The BUN:Cr in renal azotemia is less than 15.
Acute tubular necrosis due to ischemia is often preceded by prerenal acute kidney injury, since prerenal AKI results in less blood sent to the kidneys. All that secretion and reabsorption in the tubules takes a lot of energy, and so these cells are particularly sensitive to a loss of blood supply, especially the cells in the proximal tubule and ...
Under ideal situations myoglobin will be filtered and excreted with the urine, but if too much myoglobin is released into the circulation or in case of kidney problems, it can occlude the kidneys' filtration system leading to acute tubular necrosis and acute kidney injury. Other causes of myoglobinuria include: McArdle's disease
There are several causes of nephrocalcinosis that are typically acute and present only with kidney failure. [4] These include tumor lysis syndrome, acute phosphate nephropathy, and occasional cases of enteric hyperoxaluria. [4]
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