What is the Difference Between AKI and ATN

The key difference between AKI and ATN is that in AKI, the kidneys suddenly stop working properly, while ATN involves damage to the tubule cells of the kidneys.

Acute kidney injury (AKI) and acute tubular necrosis (ATN) are two associated kidney conditions. This is because acute tubular necrosis is the most common cause of acute kidney injury. However, these kidney conditions have different etiologies.

CONTENTS

1. Overview and Key Difference
2. What is AKI  
3. What is ATN
4. Similarities – AKI and ATN
5. AKI vs. ATN in Tabular Form
6. FAQ – AKI and ATN
7. Summary – AKI vs. ATN

What is AKI?

In AKI, the kidney stops working suddenly. AKI involves minor kidney function loss to complete kidney failure. AKI can be caused by reduced blood flow to the kidneys, glomerulonephritis, vasculitis, reactions to some medicines, infections, liquid dye used in some types of X-rays, and as a result of a blockage affecting the drainage of the kidneys. Moreover, the typical symptoms of an AKI may include feeling sick or being sick, diarrhea, dehydration, peeing less than usual, confusion, and drowsiness. The risk factors for AKI include age 65 or over, already having other kidney disorders, having long-term diseases like heart failure, liver disease, diabetes, dehydration, blockage in the urinary tract, severe infection like sepsis, taking certain medicines like NSAIDs, ibuprofen, blood pressure medicine like ACE inhibitors or diuretics, and taking certain types of antibiotic such as aminoglycosides.

AKI can be diagnosed through physical symptoms evaluation and blood tests. Furthermore, treatment options for AKI may include increasing water intake, taking antibiotics for certain infections, stopping taking certain medicines, using urinary catheters, and dialysis.

What is ATN?

ATN involves the death of tubular epithelial cells that form the renal tubules of the kidneys. A lack of blood flow and oxygen to the kidney tissues causes ATN. Moreover, the typical symptoms of ATN may include a small amount of urine output, swelling and fluid retention, nausea and vomiting, trouble waking up or drowsiness, feeling sluggish, and confusion. The risk factors for ATN are blood clots, extended periods of low blood pressure or shock, blood loss from surgery, and trauma.

ATN can be diagnosed through physical evaluation, blood test, urine test, and kidney biopsy. Furthermore, treatment options for ATN may include dietary restrictions that include limiting fluid, sodium, and potassium intake, diuretics, potassium-controlling medications, and dialysis.

What are the Similarities Between AKI and ATN?

• AKI and ATN are two associated kidney conditions.
• Acute tubular necrosis is the most common cause of acute kidney injury.
• Both these conditions can be diagnosed through physical symptoms evaluation and blood tests.
• They can be treated by managing underlying causes and dialysis.

What is the Difference Between AKI and ATN?

AKI is a kidney condition where the kidneys suddenly stop working properly while ATN is a kidney condition that involves damage to the tubule cells of the kidneys. Thus, this is the key difference between AKI and ATN. Furthermore, the risk factors for AKI are age 65 or over, already having other kidney disorders, having long-term diseases like heart failure, liver disease, diabetes, dehydration, blockage in the urinary tract, severe infection like sepsis, taking certain medicines like NSAIDs, ibuprofen, blood pressure medicine like ACE inhibitors or diuretics, and taking a certain type of antibiotic such as aminoglycosides. On the other hand, the risk factors for ATN are blood clots, extended periods of low blood pressure or shock, blood loss from surgery, and trauma.

The infographic below presents the differences between AKI and ATN in tabular form for side-by-side comparison.

FAQ: AKI and ATN

What is the difference between AIN and ATN?

AIN involves inflammation in the renal interstitium, commonly triggered by drug reactions or autoimmune conditions. On the other hand, ATN is characterized by damage to the kidney tubules, often caused by factors like ischemia or exposure to nephrotoxic substances.

What is the BUN creatinine ratio in ATN?

In Acute Tubular Necrosis (ATN), the blood urea nitrogen to creatinine (BUN/Cr) ratio typically falls within the normal range of 10 to 15:1. This contrasts with prerenal disease, where the ratio is often greater than 20:1. In prerenal conditions, the increased ratio is a result of the enhanced proximal reabsorption of sodium and water, leading to passive reabsorption of urea. Therefore, a high BUN/Cr ratio is indicative of prerenal disease unless another factor contributing to the elevated ratio is present.

Is urine sodium high in ATN?

Yes, in Acute Tubular Necrosis (ATN), urine sodium levels are typically elevated.

Summary – AKI vs. ATN

AKI and ATN are two associated kidney conditions. This is because acute tubular necrosis is the most common cause of acute kidney injury. However, AKI is a kidney condition where the kidneys suddenly stop working properly while ATN is a kidney condition that involves the damage to the tubule cells of the kidneys. Moreover, AKI is mainly caused by reduced blood flow to the kidney due to low blood volume after bleeding, excessive vomiting or diarrhoea, or severe dehydration, whereas ATN is mainly caused by low blood pressure and the use of nephrotoxic drugs. So, this summarizes what is the difference between AKI and ATN.

Reference:

1. “Acute Kidney Injury.” An Overview | ScienceDirect.
2. “Acute Tubular Necrosis.” MedlinePlus, U.S. National Library of Medicine.

Image Courtesy:

1. “Kidney – acute cortical necrosis” By Haymanj – Self-photographed (Public Domain) via Commons Wikimedia