• Shruti GOCHHWAL

Acute Tubular Necrosis

The kidneys are an important organ of the body that performs various essential functions like maintaining overall fluid balance in the body, regulating and filtering minerals from the blood, and filtering waste materials from food, medications, and toxic substances.

When your kidneys fail to function, it could be due to a couple of complications and necrosis is one of them.

Necrosis is the death of a cell in an organ or tissue due to the following reasons:

  1. Infectious pathogens like bacteria, viruses, fungi, parasites

  2. Oxygen deprivation or hypoxia

  3. Environmental triggers like extreme heat, radiation, or UB rays exposure or even trauma.

There are also several types of necrosis that target or affect the kidneys. They include:

  1. Fibrinoid necrosis

  2. Coagulative necrosis

  3. Acute tubular necrosis

What is Acute Tubular Necrosis?

Your kidneys are made of nephrons that have structural and functional properties in the kidneys.

Each nephron can be divided into the following parts:

  1. The Bowman’s capsule

  2. Proximal convoluted tubule

  3. Loop of Henle

  4. Distal convoluted tubule

Nephron structure

Nephron structure, Image credits: Wikimedia commons


The convoluted tubules perform the following functions:

  1. Proximal convoluted tubule Reabsorbs ions, water nutrients, removes toxins, and adjust the PH.

  2. Distal convoluted tubule Selectively secretes and absorbs different ions to maintain blood ph and electrolyte balance.

Acute tubular necrosis is a type of kidney injury that causes damage to the kidney tubule cells and as a result, it will compromise the essential functions mentioned above.

They are commonly caused by the following:

  1. Low blood flow to the kidneys

  2. Low blood pressure

  3. Excessive and harmful drugs that damage the kidneys like X-ray contrast dye, anesthesia drugs, and antibiotics

  4. Severe bodywide infections.

  5. Diabetes

  6. Stroke

  7. Heart attack

  8. Excessive blood loss during surgery or trauma

Symptoms of Acute Tubular Necrosis

Symptoms include:

  1. Dehydration

  2. Excessive thirst.

  3. Low urine output.

  4. Fluid retention

  5. Swelling

  6. Nausea

  7. Vomiting

  8. Drowsiness

  9. Sluggish

  10. Confusion or disorientation

Bloating as a symptom

Bloating as a symptom, Image credits: pixabay


What are the changes that take place in the Tubule Cells?

The following changes in the cell take place due to Necrosis:

  1. Cellular swelling

  2. Increase in cell volume

  3. Loss of plasma membrane integrity

  4. Leakage of cellular contents

  5. Cell lysis occurs

  6. Random degradation of DNA

Conclusion

Acute tubular necrosis damages the structures of the tubules and commonly causes kidney failure. When this happens, the electrolytes and fluid in the body increases to unsafe levels and can be extremely fatal to the human body.

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