Acute tubular necrosis: An old term in search for a new meaning within the evolving concept of acute kidney injury

Publication date: Available online 14 June 2015 Source:New Horizons in Translational Medicine Author(s): Sandra M. Sancho-Martínez , Laura Prieto , Víctor Blanco-Gozalo , Miguel Fontecha-Barriuso , Laura Vicente-Vicente , Alfredo G. Casanova , Marta Prieto , Moisés Pescador , Ana I. Morales , José M. López-Novoa , Carlos Martínez-Salgado , Francisco J. López-Hernández By the mid 2000s, the old term acute renal failure (ARF) was widened and superseded by the more inclusive concept of acute kidney injury (AKI). Whereas ARF referred to patients acutely needing dialysis to preserve life, AKI comprised all patients whose plasma creatinine concentration increased, or whose renal output decreased abruptly. This conceptual change primed clinical consideration, and stratification and handling criteria for a broader range of patients, hitherto not considered as such. A similar circumstance now lurks on the concept of acute tubular necrosis (ATN). ATN is the most common histo-functional pattern of a subtype of AKI, namely intrinsic AKI. In intrinsic AKI, the primary cause of AKI is posed by alterations in the renal parenchyma; as opposed to: i) pre-renal AKI, in which the primary cause is a deficit of renal blood flow resulting from decreased perfusion pressure or glomerular hemodynamic alterations; and ii) post-renal AKI, derived from obstruction of the urinary ways. The concept behind ATN has also evolved spontaneously, and without appropriate conceptual recons...
Source: New Horizons in Translational Medicine - Category: Research Source Type: research