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ACUTE TUBULAR NECROSIS

Nephrology

ACUTE TUBULAR NECROSIS

1. ATN is caused by ischemia (abrupt decrease in renal perfusion) or a nephrotoxin.

2. Nephrotoxic ATN has endogenous and exogenous causes:

• Endogenous - free myoglobin (rhabdomyolysis, page 4-37), free hemoglobin (intravascular hemolysis)

• Exogenous - contrast-related, drugs (aminoglycosides, amphotericin B, foscamet), osmotic nephropathy-IVIG with sucrose/mannitol/dextran, especially in patients with underlying chronic kidney disease, acute phosphate nephropathy, use of bowel purgatives containing sodium phosphate


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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