Kidney, acute tubular necrosis (ATN): Difference between revisions

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== Additional Info ==

Acute tubular necrosis (ATN) is a medical condition involving the death of tubular epithelial cells that form the renal tubules of the kidneys. ~~ATN presents with~~ acute kidney injury (AKI) ~~and is one of~~ the most common causes of AKI. Common causes of ATN include ~~low blood pressure~~ and use of ~~nephrotoxic drugs~~.

*Acute tubular necrosis (ATN) is a medical condition involving the death of tubular epithelial cells that form the renal tubules of the kidneys.

*It is one of many possible causes of acute kidney injury (AKI) -- also known as Acute Renal Failure. In the ICU it's among the most common causes of AKI.

*Common causes of ATN include shock, and nephrotoxic drugs.

*ATN is a diagnosis ''usually'' made clinically by: presence of AKI + presence of a known cause of ATN + urine electrolytes showing consistent findings (e.g. fractional excretion of sodium of >1%) + urine sediment showing lots of renal tubular epithelial cells.

*If you use this code, you should NOT also use the [[Kidney, acute renal failure NOS]] code -- as the latter is for types of acute renal failure that are NOT otherwise specified and ATN is exactly that, a type of acute renal failure that IS otherwise specified.

*In any case, since ATN is a specific type/cause of AKI/ARF, to qualify the patient must have AKI/ARF, as defined by KDIGO:

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== Alternate ICD10s to consider coding instead or in addition ==

*[[Chronic kidney disease ~~(chronic renal insufficiency, uremia) Stage 1]]~~

*[[Chronic kidney disease (uremia, chronic renal insufficiency) Stage 2]]

*[[Chronic kidney disease (uremia, chronic renal insufficiency) Stage 3]]

*[[Chronic kidney disease (uremia, chronic renal insufficiency) Stage 4]]

*[[Chronic kidney disease (end-stage kidney disease, ESRD), Stage 5]]

*[[Hemoglobinuria]]

*[[Anuria or oliguria]]

== Candidate [[Combined ICD10 codes]] ==

*Also code the cause, if known.

== Related CCI Codes ==

== Data Integrity Checks ==

There are a number of coding rules related to renal diagnoses, centralized info about them is in '''[[Renal Coding ~~Considerations for ICD10~~]]'''.

There are a number of coding rules related to renal diagnoses, centralized info about them is in '''[[ICD10 Guideline for Renal Coding]]'''.

~~== Related CCI Codes ==~~

== Related Articles ==

@@ Line 11: / Line 11: @@
 == Additional Info ==
-Acute tubular necrosis (ATN) is a medical condition involving the death of tubular epithelial cells that form the renal tubules of the kidneys. ATN presents with acute kidney injury (AKI) and is one of the most common causes of AKI. Common causes of ATN include low blood pressure and use of nephrotoxic drugs.
+*Acute tubular necrosis (ATN) is a medical condition involving the death of tubular epithelial cells that form the renal tubules of the kidneys.
+*It is one of many possible causes of acute kidney injury (AKI) -- also known as Acute Renal Failure.  In the ICU it's among the most common causes of AKI.
+*Common causes of ATN include shock, and nephrotoxic drugs.
+*ATN is a diagnosis ''usually'' made clinically by:  presence of AKI + presence of a known cause of ATN + urine electrolytes showing consistent findings (e.g. fractional excretion of sodium of >1%) + urine sediment showing lots of renal tubular epithelial cells.
+*If you use this code, you should NOT also use the [[Kidney, acute renal failure NOS]] code -- as the latter is for types of acute renal failure that are NOT otherwise specified and ATN is exactly that, a type of acute renal failure that IS otherwise specified.
+*In any case, since ATN is a specific type/cause of AKI/ARF, to qualify the patient must have AKI/ARF, as defined by KDIGO:
+{{ICD10 Guideline KDIGO Guidelines for Acute Renal Failure}}
 {{ICD10 Guideline ESRD vs Acute renal failure}}
@@ Line 17: / Line 24: @@
 == Alternate ICD10s to consider coding instead or in addition ==
 {{ListICD10Category | categoryName = Renal failure}}
+{{ListICD10Category | categoryName = Chronic kidney disease}}
-*[[Chronic kidney disease (chronic renal insufficiency, uremia) Stage 1]]
-*[[Chronic kidney disease (uremia, chronic renal insufficiency) Stage 2]]
-*[[Chronic kidney disease (uremia, chronic renal insufficiency) Stage 3]]
-*[[Chronic kidney disease (uremia, chronic renal insufficiency) Stage 4]]
-*[[Chronic kidney disease (end-stage kidney disease, ESRD), Stage 5]]
 *[[Hemoglobinuria]]
+*[[Anuria or oliguria]]
 == Candidate [[Combined ICD10 codes]] ==
 *Also code the cause, if known.
+== Related CCI Codes ==
 == Data Integrity Checks ==
-There are a number of coding rules related to renal diagnoses, centralized info about them is in '''[[Renal Coding Considerations for ICD10]]'''.
+There are a number of coding rules related to renal diagnoses, centralized info about them is in '''[[ICD10 Guideline for Renal Coding]]'''.
 {{Data Integrity Check List}}
-== Related CCI Codes ==
 == Related Articles ==
 {{Related Articles}}
 {{ICD10 footer}}
 {{EndPlaceHolder}}