Acute tubular necrosis (ATN)

  • Allergic: β-lactams, sulfa drugs, NSAIDs, PPIs

  • Infection: pyelo, viral, legionella, TB, leptospirosis

  • Infiltrative: sarcoid, lymphoma, leukemia

  • Autoimmune: Sjögren’s, TINU, IgG4, SLE, ICIs

Cause of acute tubular necrosis

Ischemia

  • sepsis
  • Hypovolemic
  • congestive heart failure, Cirrhosis
  • Medication that cause the decrease renal perfusion e.g. ACE inhibitor, angiotensin receptor blocker
  • Renal vascular disease: artery trhombosis, stenosis, embolization, thrombotic thrombocytopenic purpura, hemolytic uremic syndrome

Toxicity

  • aminoglycosides
  • vancomycin
  • radiocontrast
  • hemoglobin
  • myoglobin
  • heavy metal
  • chemotherapy