Necrosi tubulare acuta
Che cos’è la necrosi tubulare acuta?
La necrosi tubulare acuta è un’insufficienza renale acuta causata da una necrosi diffusa o focale delle cellule tubulari. Quando le cellule tubulari non ricevono ossigeno sufficiente oppure a causa di un farmaco tossico o molecola.
Eziologia
Insufficienza renale acuta, di cui rappresenta il 75% dei casi.
Si distinguono:
- Forma ischemica: (lesione focale dei tubuli): ipovolemia, shock settico, complicazioni ostetriche, emolisi acuta, trasfusioni incompatibili.
- Forma nefrotossica (elezioni diretta e distale dei tubuli): agenti nefrotossici.
Sintomi
I soggetti affetti da necrosi tubulare acuta sono di solito asintomatici, tuttavia se la condizione è grave si instaura l’insufficienza renale acuta, ma con una fase di ripresa della diuresi che può essere di 3 litri al giorno, con perdita di elettroliti, in particolare di potassio. Si può avere una ipopotassiemia grave. Un controllo particolare della volemia e degli elettroliti è indicato durante il periodo di ripresa della diuresi, che si caratterizza anche con una suscettibilità alle infezioni.
Prognosi
L’individuazione e il trattamento adeguato del disturbo, che ha scatenato la patologia, permettono una guarigione senza postumi.
Terapia
La terapia si identifica con quella dell’insufficienza renale acuta.
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