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عمومی::
نکروز توبولار حاد
A FeNa less than 1% is usually indicative of a prerenal cause, whereas FeNa greater than 3% indicates an intrin- sic problem such as acute tubular necrosis (ATN).
Simple urinalysis contains a wealth of information to guide the workup of AKI because a high urine specific gravity and low pH are consistent with prerenal causes of AKI, whereas the presence of tubular or muddy brown casts is indicative of renal parenchymal disease such as ATN. fte presence of eosinophils is associated with interstitial nephritis, whereas "large blood" with no red blood cells is indicative of muscle breakdown or intravascular hemolysis.
ATN in the surgical ICU is often a progression from a prerenal condition that results from oxidative or ischemic injury to renal tubular cells, but similar to AKI itself, the causes of ATN are legion.
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