Pathology - Acute Tubular Necrosis

Pathology - Acute Tubular Necrosis
Caused by renal ischemia (such as prolonged low blood pressure, shock), crush injury (such hard exercise, myoglobinuria), contrast or nephrotoxic medications (such as aminoglycosides).

Kidney pathology includes focal tubular epithelial necrosis, basement membrane rupture, eosinophilic hyaline casts in collecting ducts, interstitial edema, and indications of epithelial regeneration with flattened cells and mitotic patterns.

Symptoms and signs 
Exhibits symptoms of acute renal failure.
Arrhythmia-induced death due to hyperkalemia may happen in the early oliguric phase.
Laboratory results show oliguria, increased urinary sodium (> 40 mEq/L), azotemia, tubular epithelial cell casts (muddy-brown casts) in urine, and hyperkalemia.

Treatment involves the use of loop diuretics to induce diuresis and the monitoring of electrolyte and fluid levels, which may necessitate dialysis.
May result in the restoration of renal function or progress to end-stage renal failure (ESRD).