Acute tubular necrosis may be toxic or ischemic. It presents with acute renal failure to the point that the two concepts are used interchangeably. Acute renal failure (ARF) is a rapid loss of renal function resulting in retention of nitrogenous (urea and creatinine)and non nitrogenous waste products. ...
Toxic ATN
Histopathology: Toxic acute tubular necrosis is characterized by proximal tubular epithelium necrosis (no nuclei, intense eosinophilic homogenous cytoplasm, but preserved shape) due to a toxic substance (poisons, organic solvents, drugs, heavy metals). Necrotic cells fall into the tubule lumen, obliterating it, and determining acute renal failure. Basement membrane is intact, so the tubular epithelium regeneration is possible. Glomeruli are not affected.
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Photo at: Atlas of Pathology (http://www.pathologyatlas.ro/Toxic%20tubular%20necrosis%202.html)
Acutetubularnecrosis or (ATN) is a medical condition involving the death of tubular cells that form the tubule that transports urine to the ureters while reabsorbing 99% of the water (and highly concentrating the salts and metabolic byproducts).
Ischemic ATN occurs when the tubular cells do not get enough oxygen, a condition they are highly senistive to due to their very high metabolism.
Histopathology: Toxic ATN is characterized by proximal tubular epithelium necrosis (no nuclei, intense eosinophilic homogenous cytoplasm, but preserved shape) due to a toxic substance (poisons, organic solvents, drugs, heavy metals).
Acutetubularnecrosis (ATN) is caused by ischemia of the kidneys (lack of oxygen to the tissues) or by exposure to materials that are poisonous to the kidney (nephrotoxic agents).
ATN is one of the most common structural changes associated with the development of acute renal failure.
ATN can be caused by exposure to nephrotoxic agents such as aminoglycoside antibiotics, antifungal agents such as amphotericin, medications to prevent rejection of transplanted organs such as cyclosporine, dye used for radiographic studies, and other substances.
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