Tubular diseases

A. ATN (Acute Tubular Necrosis), the most common cause of ARF.

2 general causes:

a.ischemia. If ischemia is the cause of ATN, both PCT and DCT will be affected

b.nephrotoxins (ex: radiocontrast material, antibiotics, etc.). In this case, mainly PCT will be affected. Areas affected is also probably something that we have to know.

Tubulo-intersitual disease, second most common cause of CRF (what was the first? Answer: glomerular diseases, go back up to revew )

B. Interstitial nephritis = inflammation of intersitum, (that’s where the tubules sit). It could be acute (see PMNs) or chronic (see lymphocytes, plasma cells, maybe histiocytes)

Causes of intersitial nephritis:

1. acute and chronic pyelonephritis (to be discussed in more detail soon enough, just be patient)

2. toxins (drugs), heavy metals (Pb)

3. metabolic disease (uric acid accumulation, hypocalcemia)

4. radiation

5. tumors (ex. multiple myeloma)

6. immunologic reaction: ex: transplant rejection of kidney

Category: Nephrology Notes , Pathology Notes