Acute tubular necrosis

Acute tubular necrosis (ATN) is a medical condition involving the death of tubular epithelial cells that form the renal tubules of the kidneys. Because necrosis is often not present, the term acute tubular injury (ATI) is preferred by pathologists over the older name acute tubular necrosis (ATN).^[1] ATN presents with acute kidney injury (AKI) and is one of the most common causes of AKI.^[2] Common causes of ATN include low blood pressure and use of nephrotoxic drugs.^[2] The presence of "muddy brown casts" of epithelial cells found in the urine during urinalysis is pathognomonic for ATN.^[3] Management relies on aggressive treatment of the factors that precipitated ATN (e.g. hydration and cessation of the offending drug). Because the tubular cells continually replace themselves, the overall prognosis for ATN is quite good if the underlying cause is corrected, and recovery is likely within 7 to 21 days.^[2]