There are certain groups of people who are prone to kidney problems, like diabetic and high blood pressure patients, and even those with a family history of kidney disease. But what if catching the kidney problem early could stop it from being a full blown illness? There are some early indicators of diseases such as acute tubular necrosis.
Low urine, nausea, and swelling of the leg region, are some of the early signs of ATN disease. With acute tubular necrosis, the sooner it’s diagnosed and treated, the better the chances are of avoiding permanent kidney damage. In this article, we’ll go over the diagnostic process and treatment options available for acute tubular necrosis.
Diagnosis of Acute Tubular Necrosis
When doctors suspect a patient has acute tubular necrosis (ATN), they do a variety of tests to confirm the condition and also to check how severe it is. One of the first steps is blood tests, which will show high levels of creatinine and blood urea nitrogen (BUN). These substances are usually filtered out of the body by the kidneys. So if the blood tests show these substances, that could mean that the kidneys are not working properly, which caused them to build up in the blood.
Secondly, the doctors will perform urine tests, or urinalysis. This test will look out for all the unusual things in the urine like blood, protein, or casts; which are small clumps of cellular debris that form in the tubules when the kidney cells are damaged. When any of these substances are found in the urine, it’s a clear sign that the kidney is struggling to function properly.
Furthermore, imaging tests like ultrasounds, or CT scans allow doctors to see what’s going on inside the kidneys. These scans are what rule out other causes of kidney problems like kidney stones or blockages, that might look similar to ATN.
However, even after all these tests, the diagnosis may still be unclear. If that’s ever the case, the doctors will conduct a kidney biopsy. For this procedure, the doctors take a small sample of kidney tissue to examine under a microscope.
This will allow them to see the extent of damage to the kidney cells. They can also confirm whether ATN is the cause of kidney failure or something else.
Treatment of Acute Tubular Necrosis
Supportive Care
Supportive care is basically the foundation of treating ATN. This treatment is focused on managing whatever symptoms that come with this condition, and helping the body stay stable while the kidneys recover.
Fluid management: Managing fluid is all about making your body get just the right amount of fluid since the kidneys are having trouble filtering waste. Too much fluid can cause the legs and lungs to swell, while too little can cause dehydration and even further damage to the kidneys. So doctors carefully monitor and adjust fluid levels, sometimes giving fluid through an IV to help balance things out.
Electrolyte Correction: Electrolytes like potassium, sodium, and calcium are essential for the body to function normally. These functions include moving the muscles and heart rhythm. When the kidneys aren’t working properly, these electrolytes can become imbalanced, which can cause dangerous complications. As a result, the doctor regularly tests blood levels to make sure that the electrolytes are at the right levels. If it is needed, they will give medications or fluids to restore balance.
Blood Pressure Control: The kidneys play a major role in regulating the blood pressure in the body. When the kidneys are not working as they used to, blood pressure can either drop too low or rise too high. Low blood pressure can worsen kidney damage, while high blood pressure can lead to further harm. Doctors will monitor and treat blood pressure to keep it at a safe range, or they will use medication to help control it.
Treating the Underlying Causes
Certain drugs, referred to as nephrotoxins, have the potential to harm kidney cells. This includes contrast dye for imaging tests, certain antibiotics, and painkillers like NSAIDS. The doctor will swap out the medicine for a safer one right away if it turns out to be the cause of the problem. However, if an infection is the cause of ATN, like a severe urinary tract infection or blood infection, the doctors will use antibiotics or other treatments to clear up the infection. Once the infection is treated, the kidneys often have a better chance of recovering.
Dialysis
Dialysis is sometimes suggested by doctors when a patient’s kidneys are so damaged that they are unable to properly remove waste and fluid. During dialysis, a machine cleans the blood, removing waste, excess debris, and even poisons while the kidneys recover or heal.
Dialysis is of two main types, hemodialysis and peritoneal dialysis. On hemodialysis, a machine is used to pump blood out of the body and filter it through an artificial kidney called a dialyzer. After that, it returns the clean blood back into the body. This process is usually done in a hospital or a special dialysis center and it takes several hours to complete.
Peritoneal dialysis works a little differently than hemodialysis. Instead of using a machine, this type of dialysis uses the lining inside the abdomen called the peritoneum to filter waste. A fluid is then put into the abdomen through a tube which allows waste and extra fluids to be removed through the lining. This type of dialysis can sometimes be done at home which is more convenient for some people.
Bottom Line
Basically, if you have diabetes, high blood pressure, or a family history of kidney problems, you might be more likely to develop kidney issues like acute tubular necrosis (ATN). But if it’s discovered early, through visible symptoms like swelling, nausea, and low urine, it can be treated. Early treatment will be aimed at treating the symptoms, which can be done using methods like fluid management, medications, or even dialysis.
