Acute tubular necrosis: Symptoms & Signs, Diagnosis & Tests

Symptoms & Signs

* Decreased consciousness
o Coma
o Delirium or confusion
o Drowsy, lethargic, hard to arouse
* Decreased urine output or no urine output
* General swelling, fluid retention
* Nausea, vomiting

Note: Other symptoms of acute kidney failure may also be present.

Diagnosis & Tests

Examination usually indicates acute kidney failure. There may be signs of fluid overload, including abnormal sounds on listening to the heart and lungs with a stethoscope (auscultation).

Other signs include:

* BUN and serum creatinine levels may increase
* Fractional excretion of sodium and of urea may be relatively high
* Kidney biopsy may show acute tubular necrosis (but a biopsy is rarely done)
* Urinalysis may show casts, kidney tubular cells, and red blood cells
* Urine sodium may be high
* Urine specific gravity and osmolarity urine indicate dilute urine

Acute tubular necrosis: Overview, Causes

Acute tubular necrosis: Symptoms & Signs, Diagnosis & Tests

Acute tubular necrosis : Treatment

Review Date : 8/13/2009
Reviewed By : Parul Patel, MD, Private Practice specializing in Nephrology and Kidney and Pancreas Transplantation, Affiliated with California Pacific Medical Center, Department of Transplantation, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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