Figure 161

Ischemic acute renal failure (ARF). Flow chart illustrates the cellular basis of ischemic ARF. As described above, renal tubule epithelial cells undergo a variety of biochemical and structural changes in response to ischemic insult. If the duration of the insult is sufficiently short, these alterations are readily reversible, but if the insult continues it ultimately leads to cell detachment and/or cell death. Interestingly, unlike other organs in which ischemic injury often leads to permanent cell loss, a kidney severely damaged by ischemia can regenerate and replace lost epithelial cells to restore renal tubular function virtually completely, although it remains unclear how this happens.

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