Acute Tubular Necrosis is a frequently overlooked cause of acute kidney failure.
There are three major causes of ATN.
- Renal Ischemia
- Hypotension/Hypovolemia
- Shock
- Sepsis
- Nephrotoxins
- Contrast nephropathy
- Medications (antibiotics, antifungals, immunosuppressive agents, etc.)
- Rhabdomyolysis
Clinical data supporting a diagnosis of Acute Tubular Necrosis includes:
- Clinical history such as an episode of hypotension or exposure to a nephrotoxic agent
- AKI that lasts for > 3 days after fluid resuscitation
- Urinalysis with significant proteinuria, muddy brown casts, or epithelial cell casts
- Fractional excretion of sodium is > 2%
Documentation Examples:
- “Acute renal failure secondary to probable ATN”
Download the complete tip, Acute Tubular Necrosis (ATN).