Final answer:
Ischemia and nephrotoxic injury are the two major causes of acute tubular necrosis (ATN), which is a common cause of acute kidney injury (AKI) and can lead to significant mortality rates in hospitalized patients.
Step-by-step explanation:
The two major causes of acute tubular necrosis (ATN) are ischemia and nephrotoxic injury. Ischemic ATN occurs when there's a sudden reduction in blood flow to the kidneys, which can happen during shock, severe dehydration, or as a complication of surgery. Nephrotoxic ATN, on the other hand, results from the harmful effects of substances such as drugs (e.g. aminoglycoside antibiotics, NSAIDs), toxins, or the muscle breakdown product myoglobin, which can occur after severe muscle injury.
Acute tubular necrosis is a common cause of acute kidney injury (AKI), which can affect 7-10% of all hospitalized patients and result in significant mortality rates. It is distinct from other kidney conditions such as glomerulonephritis and pyelonephritis, both of which can also impact renal function but via different mechanisms.