Every day, your kidneys filter about 50 gallons of blood. This process is done through tiny tubular cells. They remove waste and balance fluids to keep your body functioning. But what happens when the tubular cells become damaged? This is not a case scenario, because having damaged tubular cells is possible. It’s a condition called Acute Tubular Necrosis (ATN), which is a condition that disrupts kidney function, leading to acute kidney injury.
What is Acute Tubular Necrosis (ATN)?
ATN is a condition that happens when the tiny cells lining the kidney tubules get damaged. Typically, your kidneys act as filters, cleaning your blood and removing waste through a network of small tubes called tubules. These tubules are lined with specialized cells, called tubular cells, which absorb water, sugar, and salts, and return them to your bloodstream while still getting rid of harmful waste.
In ATN, these tubular cells get injured because of a lack of oxygen or being exposed to harmful substances. This can happen during severe dehydration, low blood pressure, and many more. Once the cells are damaged, they won’t work properly. These cells can die and begin to shed into the tubules, clogging them up. Because of this, the kidneys find it hard to filter blood efficiently.
Symptoms of Acute Tubular Necrosis
There are symptoms a person notices at first when their tubules begin to die. These symptoms are considered to be markers or an early indication of this condition. They include:
- Low urine
- Tiredness
- Swelling in the legs, ankles, or feet
- Nausea
- Loss of appetite
Overtime, if not treated the condition will progress, which will cause the dead tubules to shed and fall into the lumen (the hollow inside) of the kidney tubules. If that happens, the person will likely experience symptoms like:
- Dark or bloody urine
- High blood pressure
- Confusion
- Shortness of breath
- Irregular heartbeats
- Constant itching
- Muscle cramps
Causes of Acute Tubular Necrosis
Ischemia (Reduce Blood Flow): The kidneys are always in need of a steady supply of blood to function. Blood carries oxygen and nutrients that keep kidney cells alive. However, if the blood flow to the kidney reduces significantly, because of dehydration, stroke, or maybe surgery, the kidney cells won’t get enough oxygen. Without oxygen, the cells start to die. This lack of blood flow and oxygen is called ischemia, which is one of the causes of ATN.
Nephrotoxins: Nephrotoxins are substances that are poisonous to the kidneys. They can damage delicate cells inside the tubules, which makes it harder for the kidneys to do their jobs.
Nephrotixins come in different forms, they can be certain medications, contrast dyes, heavy metals, or even poison. Some medications like NSAIDs can be harmful to the kidneys if used excessively or without proper monitoring. While contrast dyes are dyes used during medical imaging tests which allows the doctor to see the organs better. They can stress the kidneys out and damage delicate cells.
Other Causes: Besides low blood flow, and nephrotoxins, acute tubular necrosis can be caused by other conditions like infections, autoimmune diseases, and rhabdomyolysis. These are less common but they can still lead to ATN. For rhabdomyolysis, this condition happens when muscle tissues break down quickly due to injury, drugs, or intense workouts.
This breakdown releases a protein called myoglobin into the bloodstream. Myoglobin is toxic to the kidneys and clogs the tubules, leading to ATN. In all, the common causes are as a result of low oxygen and exposure to toxins which affect the cells and reduce kidney function.
Bottom Line
Acute Tubular Necrosis (ATN) is a condition that damages the kidneys’ filtering system, making it difficult for them to remove waste and maintain the body’s fluid and chemical balance. This damage happens when the tiny tubular cells in the kidneys are harmed, often due to a lack of blood flow or exposure to harmful substances like toxins or certain medications. If left untreated, ATN doesn’t just stop the kidneys from working properly; it can lead to severe kidney injury, where waste and toxins build up dangerously in the body. This can cause life-threatening complications.
