ATN vs. AIN

ATN: Acute tubular necrosis leads to ARF. Causes: 1) ischemic: globar ischemia, shock, hemorrhage, sepsis, DIC 2) nephrotoxic: aminoglycosides, radiocontrast, NSAIDs (especially in the setting of CHF), poisons, myoglobinuria, hemoglubinuria, cisplastin, multiple myeloma (kappa and gamma light chains). Dx: elevation of BUN and Cr and decrease in UOP consistant with ARF

AIN: Acute interestitial nephritis inflammation of the glomerular and tubular interestitium. 10% risk of ARF. Causes: acute allergic reaction to medications (e.g. penicillins, NSAIDs, anticoagulants, thiazides, furosemide, phenytoin, sulfa drugs), infection (streptococcus and legionella pneumophilia), CVD (e.g. sarcoidosis). Dx: increased BUN, Cr, eosinophiluria