急性肾小管坏死（英语：Acute tubular necrosis，缩写ATN）为涉及肾脏肾小管上皮细胞坏死的医学病症。ATN伴随着急性肾损伤（acute kidney injury，AKI），并且是AKI的最常见的病因之一。ATN常见的病因包括低血压，及使用肾毒性药物。尿液分析时在尿中发现上皮细胞的「棕色浑浊管型尿液」是ATN的特异病征性。ATN的治疗依靠的是沉淀ATN（比如水化及停止使用违规药物）的因素进行。由于肾小管的上皮细胞会不断自行更替，如果病因在发现及治疗后、则ATN的整体预后是相当不错的，且可能在7到21天左右康复。

Acute tubular necrosis (ATN) is a medical condition involving the death of tubular epithelial cells that form the renal tubules of the kidneys. ATN presents with acute kidney injury (AKI) and is one of the most common causes of AKI. Common causes of ATN include low blood pressure and use of nephrotoxic drugs. The presence of "muddy brown casts" of epithelial cells found in the urine during urinalysis is pathognomonic for ATN. Management relies on aggressive treatment of the factors that precipitated ATN (e.g. hydration and cessation of the offending drug). Because the tubular cells continually replace themselves, the overall prognosis for ATN is quite good if the cause is corrected, and recovery is likely within 7 to 21 days.