What is acute tubular injury?

➢ Acute tubular injury (ATI) is a clinicopathologic entity characterized by damage to tubular epithelial cells and an acute decline in renal function, often associated with shedding of granular casts and tubular cells into the urine. ➢ Clinicians use the term acute tubular necrosis, but frank necrosis is rarely observed in a kidney biopsy, so pathologists prefer the term acute tubular injury. ➢ The constellation of changes, broadly termed acute kidney injury, manifests clinically as decreased GFR with concurrentelevation of serum creatinine. ➢ ATI is the most common cause of acute kidney injury and may produce oliguria ➢ There are two forms of ATI that differ in the underlying causes. • Ischemic ATI is most often the result of a period of inadequate • Nephrotoxic ATI