In general, kidney disease is a relatively slow development disease, according to the general response of these patients, the natural case of glomerular filtration rate decreased by 3 - 5ml/min. But there are also cases of acute kidney injury, two days it is difficult to urinate, and may even endanger life. Among these, acute tubular necrosis is one of the most common causes.
How to diagnose acute tubular necrosis? Through the analysis of urine found in the epithelial cells of the brown turbid urine tube is pathognomonic of acute tubular necrosis. What is the cause of acute tubular necrosis? There are two common causes of acute tubular necrosis: toxicity and ischemia, so be sure to guard against these two points, especially in patients with renal function has begun to decline. In addition, hemolysis, infection is also the cause. The first said: toxic chemicals and heavy metals are likely to cause necrosis, drugs include antibiotics, such as aminoglycosides gentamicin, statins such as atorvastatin, and cytotoxic drugs such as cisplatin, or by poisoning ("antifreeze"); heavy metal mercury and arsenic, lead, lithium. The focus is on ischemia, and in general, acute tubular necrosis caused by ischemia is more severe. May be caused by renal artery stenosis and bleeding (such as falls or major surgery caused by bleeding), caused by various reasons such as shock. It should be noted that the above reasons can exist at the same time.
Treatment should be fast
Treatment is mainly in the following two aspects:
1. correct water and electrolyte acid-base balance. This is the most important, because of severe arrhythmia caused by excessive water load and pulmonary edema caused by hyperkalemia, which is the two leading cause of life-threatening acute renal tubular necrosis.
2. to correct anemia, control of infection, disable the above two drugs are difficult to control kidney dialysis. It is best to control the acute tubular necrosis within a month, so that it can be used for six months to a year to restore the function of the kidney; if more than a month, it is difficult to restore renal function. In fact, the greatest harm of acute tubular necrosis is not a short period of time of kidney damage, this can be saved, but this illusion often mistaken has developed into uremia that began permanent dialysis. So we should pay attention to, acute tubular necrosis though menacing, but also can cure, do not treat as a general uremia. Because the tubular epithelial cells will continue to change, if the cause can be found and treated in time, the overall prognosis of acute tubular necrosis is quite good, and may be around 7 to 21 days to recover.