What is likely to cause a patient's renal issues after an amlodipine overdose?

Acute tubular necrosis (ATN) is a likely consequence of an amlodipine overdose due to the direct effects of the drug on renal blood flow and kidney function. Amlodipine is a calcium channel blocker primarily used to treat hypertension and angina, and in excessive amounts, it can lead to significant vascular changes.

In the case of an overdose, the resulting hypotension may impede renal perfusion, leading to ischemia. Ischemic damage to the renal tubules can result in acute tubular necrosis, characterized by the destruction of tubular epithelial cells. This condition is often marked by a sudden decrease in kidney function, elevated serum creatinine levels, and the presence of tubular injury markers in the urine.

Other conditions listed do not typically arise from an overdose of amlodipine. Pyelonephritis is an infection of the kidneys, chronic kidney disease refers to a gradual loss of kidney function over time, and glomerulonephritis involves inflammation of the glomeruli, neither of which is directly linked to amlodipine toxicity. Thus, acute tubular necrosis is the most plausible renal complication following an overdose of this medication.