Acute tubular necrosis risk factors

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chandrakala Yannam, MD [2]

Overview

Common risk factors in the development of acute tubular necrosis include any condition that lead to decreased renal perfusion such as recent abdominal and cardiac surgery, marked hypovolemia, sepsis, hemorrhagic shock, severe pancreatitis, and diabetes mellitus. Nephrotoxic medications ( eg, ACE inhibitors, NSAIDs, aminoglycosides, radio contrast media) can also be a risk for developing acute tubular necrosis.

Risk Factors

Common Risk Factors

Common risk factors in the development of acute tubular necrosis include:
- Surgery^[1]^[2] (eg, abdominal aortic aneurysm surgery, cardiac surgery)
- Septic shock^[3]
- Hypovolemia
- Hemorrhage
- Severe acute pancreatitis^[4]
- Drugs:^[5]^[6]
  - ACE inhibitors
  - Aminoglycosides
  - NSAIDs
  - Amphotericin B
  - Radio contrast media
  - Ethylene glycol poisoning
  - Antiviral drugs
- Profound hypotension
- Diabetes mellitus^[7]
- Malignancy^[8] (eg, multiple myeloma)
- Congestive heart failure
- Cirrhosis^[9]
- Tissue injury (eg, rhabdomyolysis)
- Chronic renal disease^[10]
- Morbid obesity
- Disseminated intravascular coagulation
- Peripheral vascular disease (atherosclerosis, intermittent claudication)

References

↑ Wald R, Waikar SS, Liangos O, Pereira BJ, Chertow GM, Jaber BL (March 2006). “Acute renal failure after endovascular vs open repair of abdominal aortic aneurysm”. J. Vasc. Surg. 43 (3): 460–466, discussion 466. doi:10.1016/j.jvs.2005.11.053. PMID 16520155.
↑ Nigwekar SU, Kandula P, Hix JK, Thakar CV (September 2009). “Off-pump coronary artery bypass surgery and acute kidney injury: a meta-analysis of randomized and observational studies”. Am. J. Kidney Dis. 54 (3): 413–23. doi:10.1053/j.ajkd.2009.01.267. PMID 19406542.
↑ Alobaidi R, Basu RK, Goldstein SL, Bagshaw SM (January 2015). “Sepsis-associated acute kidney injury”. Semin. Nephrol. 35 (1): 2–11. doi:10.1016/j.semnephrol.2015.01.002. PMC 4507081. PMID 25795495.
↑ Petejova N, Martinek A (June 2013). “Acute kidney injury following acute pancreatitis: A review”. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 157 (2): 105–13. doi:10.5507/bp.2013.048. PMID 23774848.
↑ Ghane Shahrbaf F, Assadi F (2015). “Drug-induced renal disorders”. J Renal Inj Prev. 4 (3): 57–60. doi:10.12861/jrip.2015.12. PMC 4594214. PMID 26468475.
↑ Berns AS (October 1989). “Nephrotoxicity of contrast media”. Kidney Int. 36 (4): 730–40. PMID 2681935.
↑ Girman CJ, Kou TD, Brodovicz K, Alexander CM, O’Neill EA, Engel S, Williams-Herman DE, Katz L (May 2012). “Risk of acute renal failure in patients with Type 2 diabetes mellitus”. Diabet. Med. 29 (5): 614–21. doi:10.1111/j.1464-5491.2011.03498.x. PMID 22017349.
↑ Faiman BM, Mangan P, Spong J, Tariman JD (August 2011). “Renal complications in multiple myeloma and related disorders: survivorship care plan of the International Myeloma Foundation Nurse Leadership Board”. Clin J Oncol Nurs. 15 Suppl: 66–76. doi:10.1188/11.CJON.S1.66-76. PMC 3433942. PMID 21816711.
↑ Moreau R, Lebrec D (February 2003). “Acute renal failure in patients with cirrhosis: perspectives in the age of MELD”. Hepatology. 37 (2): 233–43. doi:10.1053/jhep.2003.50084. PMID 12540770.
↑ James MT, Hemmelgarn BR, Wiebe N, Pannu N, Manns BJ, Klarenbach SW, Tonelli M (December 2010). “Glomerular filtration rate, proteinuria, and the incidence and consequences of acute kidney injury: a cohort study”. Lancet. 376 (9758): 2096–103. doi:10.1016/S0140-6736(10)61271-8. PMID 21094997.

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[pmid16520155-1] Wald R, Waikar SS, Liangos O, Pereira BJ, Chertow GM, Jaber BL (March 2006). “Acute renal failure after endovascular vs open repair of abdominal aortic aneurysm”. J. Vasc. Surg. 43 (3): 460–466, discussion 466. doi:10.1016/j.jvs.2005.11.053. PMID 16520155.

[pmid19406542-2] Nigwekar SU, Kandula P, Hix JK, Thakar CV (September 2009). “Off-pump coronary artery bypass surgery and acute kidney injury: a meta-analysis of randomized and observational studies”. Am. J. Kidney Dis. 54 (3): 413–23. doi:10.1053/j.ajkd.2009.01.267. PMID 19406542.

[pmid25795495-3] Alobaidi R, Basu RK, Goldstein SL, Bagshaw SM (January 2015). “Sepsis-associated acute kidney injury”. Semin. Nephrol. 35 (1): 2–11. doi:10.1016/j.semnephrol.2015.01.002. PMC 4507081. PMID 25795495.

[pmid23774848-4] Petejova N, Martinek A (June 2013). “Acute kidney injury following acute pancreatitis: A review”. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 157 (2): 105–13. doi:10.5507/bp.2013.048. PMID 23774848.

[pmid26468475-5] Ghane Shahrbaf F, Assadi F (2015). “Drug-induced renal disorders”. J Renal Inj Prev. 4 (3): 57–60. doi:10.12861/jrip.2015.12. PMC 4594214. PMID 26468475.

[pmid2681935-6] Berns AS (October 1989). “Nephrotoxicity of contrast media”. Kidney Int. 36 (4): 730–40. PMID 2681935.

[pmid22017349-7] Girman CJ, Kou TD, Brodovicz K, Alexander CM, O’Neill EA, Engel S, Williams-Herman DE, Katz L (May 2012). “Risk of acute renal failure in patients with Type 2 diabetes mellitus”. Diabet. Med. 29 (5): 614–21. doi:10.1111/j.1464-5491.2011.03498.x. PMID 22017349.

[pmid21816711-8] Faiman BM, Mangan P, Spong J, Tariman JD (August 2011). “Renal complications in multiple myeloma and related disorders: survivorship care plan of the International Myeloma Foundation Nurse Leadership Board”. Clin J Oncol Nurs. 15 Suppl: 66–76. doi:10.1188/11.CJON.S1.66-76. PMC 3433942. PMID 21816711.

[pmid12540770-9] Moreau R, Lebrec D (February 2003). “Acute renal failure in patients with cirrhosis: perspectives in the age of MELD”. Hepatology. 37 (2): 233–43. doi:10.1053/jhep.2003.50084. PMID 12540770.

[pmid21094997-10] James MT, Hemmelgarn BR, Wiebe N, Pannu N, Manns BJ, Klarenbach SW, Tonelli M (December 2010). “Glomerular filtration rate, proteinuria, and the incidence and consequences of acute kidney injury: a cohort study”. Lancet. 376 (9758): 2096–103. doi:10.1016/S0140-6736(10)61271-8. PMID 21094997.

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Acute tubular necrosis risk factors

Overview

Risk Factors

Common Risk Factors

References

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