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Acute tubular necrosis (ATN) is the second most common cause of acute kidney injury in the hospital setting after prerenal azotaemia. It occurs in three clinical stages (initial, maintenance and recovery) and is associated with polyuria in the recovery phase. The duration of both the oliguric (maintenance) and the diuretic phase of acute tubular necrosis is unpredictable, lasting from days to weeks, with the average durations of oliguria and diuresis being 11.6 and 12 days, respectively. Further, the urine output rarely exceeds 7–8 L in 24 h. Examines the role of this case report a short oliguric phase (24 h or sometime less) in the potentiation of prolonged, marked polyuria on the recovery phase. The early recognition of AKI in such high-risk patients with Gram-negative septicaemia or other hypo perfused states is imperative. Intravenous fluids hydration to match on-going losses early in the course of renal injury can prevent a secondary renal insult and offset progression to chronic renal failure or you can say dialysis dependence.
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