Acute Tubular Necrosis


Acute tubular necrosis is damage to the tubule cells (tiny tube-shaped cells) in the kidney that results in acute kidney failure . This is a potentially serious condition that requires medical care.

Anatomy of the Kidney
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Acute tubular necrosis can be caused by:

  • Lack of oxygen to kidney tissues from problems such as blood clots, surgical complications, severe dehydration, or heavy bleeding
  • Exposure to toxic materials such as antibiotics, x-ray dyes, or anesthetics

Risk Factors

Factors that may increase your chance of acute tubular necrosis include:

  • Injury
  • Trauma
  • Surgery
  • Blood transfusion
  • Septic shock
  • Shock
  • Low blood pressure
  • Liver disease or damage
  • Certain medications, such as aminoglycosides, amphotericin B, cyclosporine, or tacrolimus
  • X-ray dye
  • Blood transfusion reaction
  • Exposure or build up of toxic chemicals, such as:
    • Crystals (uric acid, calcium phosphate)
    • Myoglobin
    • Hemoglobin


Acute tubular necrosis may cause:

  • Change in urine output
  • General swelling, fluid retention
  • Nausea, vomiting
  • Dehydration


Your doctor will ask about your symptoms and medical history. A physical exam will be done.

Tests may include:

  • Blood tests
  • Urine tests
  • Kidney biopsy

Imaging tests evaluate the kidneys and surrounding structures. These may include:


Talk with your doctor about the best treatment plan for you. Treatment will focus on treating the conditions that are causing damage. Good nutrition and proper fluid intake will also help reduce stress on the kidneys during recovery. Treatment options may also include:


Dialysis is a process that uses a machine to assist or take over the work of your kidneys. The blood flows from catheters to a machine that removes wastes and returns it back to the body.


Certain medications may reduce the need for dialysis in some people.


Acute tubular necrosis is sometimes the result of an accident. If you have kidney disease or a history of kidney problems, follow your doctor's instructions after surgical procedures or imaging test that required contrast dyes.


Please note, not all procedures included in this resource library are available at Allegiance Health or performed by Allegiance Health physicians.

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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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