Definition of Acute tubular necrosis. Acute tubular necrosis: A severe form of acute renal failure that develops in people with severe illnesses (such as sepsis) or with very low blood pressure. Patients may need dialysis. Kidney function often improves if the underlying disease is successfully treated. Abbreviated ATN.
Buying a tow dolly can cost  $1,000-$4,500, depending on towing capacity, size, quality of materials and other options. For example, the Roadmaster RM3477 Tow Dolly with built-in electric brakes sells for $1,600 -$2,000, and can tow a vehicle weighing up to 4,250 pounds.
A pickup to tow the fifth wheel can cost $20,000-$50,000 or more. Towing a loaded fifth wheel will reduce the pickup's fuel efficiency by at least a couple miles per gallon, and could cut it by as much as half (or more). Some fifth wheel owners report getting 8-10 mpg while towing.