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{{Acute tubular necrosis}}
{{Acute tubular necrosis}}
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==Overview==
==Overview==
ATN can be broadly classified into ischemic or toxin-induced.
Acute tubular necrosis may be classified based on mechanisms of [[Renal tubule|tubular]] [[injury]] into three categories including ischemic, toxin-induced, and mixed.


==Classification==
==Classification==
ATN can be classified based on the underlying pathologic mechanisms involved. Broadly ATN can be secondary to either renal ischemia or toxin-mediated injury.<ref name="pmid16811078">{{cite journal| author=Dunnill MS| title=A review of the pathology and pathogenesis of acute renal failure due to acute tubular necrosis. | journal=J Clin Pathol | year= 1974 | volume= 27 | issue= 1 | pages= 2-13 | pmid=16811078 | doi= | pmc=PMC477978 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16811078  }} </ref>
* Acute tubular necrosis may be classified into three categories based on the mechanisms of [[Renal tubule|tubular]] [[injury]] involved.<ref name="pmid16646986">{{cite journal |vauthors=Santos WJ, Zanetta DM, Pires AC, Lobo SM, Lima EQ, Burdmann EA |title=Patients with ischaemic, mixed and nephrotoxic acute tubular necrosis in the intensive care unit--a homogeneous population? |journal=Crit Care |volume=10 |issue=2 |pages=R68 |date=2006 |pmid=16646986 |pmc=1550879 |doi=10.1186/cc4904 |url=}}</ref>
The pathogenesis, structural changes, prognosis, and treatment are considerably different between these two entities. <ref name="pmid17728549">{{cite journal| author=Mennel S, Barbazetto I, Meyer CH, Peter S, Stur M| title=Ocular photodynamic therapy--standard applications and new indications. Part 2. Review of the literature and personal experience. | journal=Ophthalmologica | year= 2007 | volume= 221 | issue= 5 | pages= 282-91 | pmid=17728549 | doi=10.1159/000104757 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17728549  }} </ref><ref name="Fogo">Fogo A, Cohen AH, Colvin RB et al. Fundamentals of Renal Pathology. Springer 2013.  Acute Tubular Necrosis. http://dx.doi.org/10.1007/978-3-642-39080-7_15 </ref>
** Ischemic acute tubular necrosis
** Nephrotoxic acute tubular necrosis
** Mixed acute tubular necrosis
* Ischemic [[Acute tubular necrosis|ATN]] resulting from conditions leading to inadequate blood flow and oxygenation to the [[Kidney|kidneys]] during 48 hrs (eg, [[shock]], [[sepsis]], [[Bleeding|hemorrhage]], [[Hypovolemia|volume loss]], and [[hypotension]]) without nephrotoxin exposure that results in [[Acute kidney injury|acute renal failure]] and rise in serum [[creatinine]] levels.
* Nephrotoxic [[Acute tubular necrosis|ATN]] occurs as a result of exposure of [[Kidney|kidneys]] to various nephrotoxic [[Medication|medications]] and chemicals (eg, [[Aminoglycoside|aminoglycosides]], [[Radiocontrast|radiocontrast media]], [[ACE inhibitor|ACE inhibitors]], [[Non-steroidal anti-inflammatory drug|NSAIDs]], [[cyclosporine]], and [[Sulfonamide (medicine)|sulfa drugs]]) during 72 hrs preceding the increase in serum [[creatinine]].
 


==References==
==References==
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Latest revision as of 15:36, 9 June 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chandrakala Yannam, MD [2]

Overview

Acute tubular necrosis may be classified based on mechanisms of tubular injury into three categories including ischemic, toxin-induced, and mixed.

Classification


References

  1. Santos WJ, Zanetta DM, Pires AC, Lobo SM, Lima EQ, Burdmann EA (2006). "Patients with ischaemic, mixed and nephrotoxic acute tubular necrosis in the intensive care unit--a homogeneous population?". Crit Care. 10 (2): R68. doi:10.1186/cc4904. PMC 1550879. PMID 16646986.