Hello and welcome to the zero to finals podcast. My name is Tom and in this episode I'm going to be

talking to you about acute tubular necrosis. And if you want to follow along with written notes on

this topic, as always you can follow along at zero to finals.com slash a.T.N.

Or in the renal section of the 0-2-finals medicine book.

Let's get straight into it.

Acute tubular necrosis is damage and death.

Remember death we call necrosis of the epithelial cells of the renal tubules.

And these are the cells that line the tubules.

This is the most common cause of acute kidney injury.

Damage to the kidney cells occurs due to ischemia or due to toxins.

The epithelial cells have the ability to regenerate, which means that acute tubular

necrosis is reversible, and it usually takes 7 to 21 days to make full recovery. So what are the

causes of acute tubular necrosis? Well, the ischemia that leads to the necrosis of the

epithelial cells can occur secondary

to hypopperfusion, so a low perfusion with blood, in shock or in sepsis, or in severe dehydration.

Direct damage can also result from toxins, which occur due to radiology contrast dyes.

So a patient might go for a CT scan where they have a contrast die injected,

which damages the epithelial cells and leads to acute tubular necrosis.

It might be toxins like gentomicin, non-steroidal anti-inflammatory drugs like neproxin,

lithium, which can be used to treat things like bipolar effective disorder, and heroin can also cause acute tubular necrosis.

It's worth remembering when you do a urinalysis investigation in a patient who has acute tubular

necrosis, you can find something

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