General Nephrotoxic Factors
The nephron
Cortex
The nephron
Cortex
t 1 Lithium ! ! Ischemia
Vulnerability of the kidney
Sites of renal damage
^ ACE inhibitors ^ NSAIDs ( ) Aminoglycosides
Acyclovir ^^^^ Cisplatinum HgCl2
t 1 Lithium ! ! Ischemia
Vulnerability of the kidney
•Important blood flow (1/4 cardiac output)
• High metabolic activity
• Largest endothelial surface by weight •Multiple enzyme systems •Transcellular transport •Concentration of substances •Protein unbinding
•High O2 consumption/delivery ratio in outer medulla
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