American Board of Pathology (ABPath) 2025 – 400 Free Practice Questions to Pass the Exam

Acute Tubular Necrosis (ATN) is recognized as the most common cause of renal failure in hospitalized patients. This condition typically arises from a variety of factors, including ischemia, nephrotoxins, and sepsis, which can lead to damage of the renal tubular cells.

In a hospital setting, patients often experience situations that can precipitate ATN, such as surgery, dehydration, or the use of certain medications that are nephrotoxic. When the kidney's tubules are damaged, their ability to reabsorb water and electrolytes is compromised, leading to acute kidney injury and a resultant decline in renal function.

While Acute Kidney Injury (AKI) is a broader category that encompasses various forms of renal impairment, ATN is frequently the specific type of AKI encountered most often in hospital patients. Chronic Kidney Disease (CKD) and Diabetic Nephropathy refer to long-standing conditions that typically do not develop acutely during a hospital stay, making them less relevant as a primary cause in this context.

Thus, ATN's prevalence in the acute setting of hospitalization, often linked to specific insult mechanisms, solidifies its position as the leading cause of renal failure among hospitalized patients.