Acute Tubular Injury (ATI)

• Necrosis of tubular epithelium – fall off as casts.

• Common cause of Renal ARF - 50%

• Reversible

  

Ischemic type

• patchy PCT and DCT
• Hypovolemia, Shock
• DIC, HUS, TTP etc.

ATN: ischemic type. all tubules appear red, dying, pyknotic nuclei, many lost.

Toxic type

• PCT only as majority toxin exposure
• Drugs, Toxins, Mercury, CCL4, Radiocontrast.
• Hemoglobin, myoglobin, bilirubin, immunoglobulins.

ATN: toxic. normal glomeruli, PCT lost nucleus. normal DCT