Causes of Acute Tubular Necrosis

What are the causes of Acute Tubular Necrosis?

Acute Tubular Necrosis may develop as the result of hypotension and kidney ischemia in the setting of sepsis with or without overt hypotension, or as the result of nephrotoxin exposure. Ischemia contributes to approximately 60% to 70% of cases of Acute Tubular Necrosis, 50% to 60% of sepsis, and 30% to 40% of nephrotoxins.

The nephrotoxins commonly associated with the development of Acute Tubular Necrosis are listed below

Common Etiologies of Acute Tubular Necrosis

  • Nephrotoxic
  • Exogenous
    • Radiocontrast agents
    • Aminoglycosides
    • Vancomycin
    • Amphotericin B
    • Cisplatinum
    • Acetaminophen
  • Endogenous
    • Hemoglobin
    • myoglobin
  • Ischemic
    • prolonged prerenal azotemia
    • hypotension
    • hypovolemic shock
    • cardiopulmonary arrest
    • cardiopulmonary bypass
    • aortic surgery
  • Sepsis

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