Diseases of the Kidney Tubules

Tubular necrosis (death of kidney tissue) can be caused by lack of oxygen (e.g., from blood loss or low blood pressure due to surgery or trauma). It can also be caused by a kidney toxin, like a drug, a transfusion with the wrong blood type, or a dye used for X-ray tests.

Symptoms may include swelling, less urine, nausea, vomiting, and coma.1 This problem is the most common cause of acute (sudden) kidney failure.2 Rarely, it can cause long-term kidney failure. It causes about 2% of kidney failure each year in the US.3

What You Can Do

Take action to prevent tubular necrosis or protect kidney function if you or a loved one has this problem:

  • Check out new drugs. Before you take a drug for the first time, do a little homework. Look them up at http://www.rxlist.com. Or ask the druggist if there are side effects or warnings you should know about.
  • Watch for allergies. When you take a new drug, note any changes in your body. Report new symptoms to your doctor and ask if they might be due to a drug.
  • Ask for blood levels of a kidney toxic drug. When you must take a drug that can harm the kidneys, ask your doctor about checking your blood levels to be sure they are in a safe range.
  • Check the label on a blood transfusion bag. Most hospitals require two people to check that a bag of blood is the right blood type for the patient. You can be one of these people.
  • Ask for X-ray dye precautions. Your doctor can make X-ray dye less harmful. It can be made more dilute, less dye can be used, a less harmful dye can be used, and you can have the dye flushed out of your system after the X-ray.
  • Treat other health problems. Keeping diabetes, heart problems or liver disease in good control will also help you protect your kidneys.
  • Seek out a specialist. Find a doctor who knows what you are up against and what the current research says. No doctor can stay up to date on every illness. Ask for a referral to an expert who can consult with your doctor.

Questions to Ask Your Doctor About Tubular Necrosis

  1. How often will you check my kidney function if I take this drug?
  2. How often will you check the level of this drug in my blood?
  3. How can we be sure that my kidneys won’t be harmed by the X-ray dye?
  4. How long will it take to know if my kidneys are recovering?
  5. Will any treatments help my kidneys to recover?

Links to Learn More

1 http://www.nlm.nih.gov/medlineplus/ency/article/000512.htm 2 http://www.nephrologychannel.com/atn/ 3 USRDS 2006 ADR, table A.7