Acute tubular necrosis may be toxic or ischemic. It presents with acute renal failure to the point that the two concepts are used interchangeably.

Toxic ATN

Histopathology: Toxic acute tubular necrosis is characterized by proximal tubular epithelium necrosis (no nuclei, intense eosinophilic homogenous cytoplasm, but preserved shape) due to a toxic substance (poisons, organic solvents, drugs, heavy metals). Necrotic cells fall into the tubule lumen, obliterating it, and determining acute renal failure. Basement membrane is intact, so the tubular epithelium regeneration is possible. Glomeruli are not affected.

External link

Photo at: Atlas of Pathology