DONALD T. LEWERS, M.D.; TIMOTHY H. MATHEW, M.B.B.S., M.R.C.P.; JOHN F. MAHER, M.D., F.A.C.P.; GEORGE E. SCHREINER, M.D., F.A.C.P.
Renal function and histology were evaluated in 30 patients surviving acute tubular necrosis who were followed from 2 to 15 years. Clinical recovery was complete in all patients. Endogenous creatinine clearance was abnormal in 37%, whereas 47% failed to concentrate their urine to an osmotic urine to plasma ratio of 3.0. Two patients have an unexplained progressive deterioration in glomerular filtration rate. Ischemic acute tubular necrosis was followed by an abnormal creatinine clearance in 44% compared with 25% of those with a toxic cause. Toxic acute tubular necrosis was followed by a concentrating defect in 58% compared with 39% of the ischemic group. Phenolsulfonphthalein, intravenous pyelogram, maximal acid excretion, urinalysis, and urine cultures were abnormal in fewer patients. Renal histological changes were minimal and nonspecific. Patients recovering from acute tubular necrosis are clinically normal, and most have normal renal histology. Renal function will approach but not always achieve normal levels in the majority. Progressive deterioration of renal function may occasionally occur.
LEWERS DT, MATHEW TH, MAHER JF, SCHREINER GE. Long-Term Follow-up of Renal Function and Histology After Acute Tubular Necrosis. Ann Intern Med. ;73:523–529. doi: 10.7326/0003-4819-73-4-523
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Published: Ann Intern Med. 1970;73(4):523-529.
Acute Kidney Injury, Nephrology.
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