Acute Tubular Necrosis Caused by Severe Renal Ischemia Severe ischemia of the
kidney can result from circ latory shock or any other disturbance that severely impairs the blood
supply to the kidney. If the ischemia is severe enough to seriously impair the delivery of nutrients and
oxygen to the renal tubular epithelial cells, and if the insult is prolonged, damage or eventual
destruction of the epithelial cells can occur.
Acute Tubular Necrosis Caused by Toxins or Medications There is a long list of renal poisons and medications that can damage the tubular epithelium and
cause acute renal failure. Some of these are carbon tetrachloride, heavy metals (such as mercury and
lead), ethylene glycol (which is a major component in antifreeze), various insecticides, some
medications (such as tetracyclines) used as antibiotics, and cis-platinum, which is used in treating
certain cancers.
