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different processes are required to achieve structural and functional integrity of the kidney after a toxic or ischemic insult: 1) uninjured cells must proliferate and reepithelialize damaged nephron segments; 2) nonlethally damaged cells must recover;

and 3) some damaged cells may actually dieā€”not as a result of the initial insult but through a process of programmed cell death known as apoptosis. Figure 17-1 provides a schematic representation of the renal response to an ischemic or toxic injury.

Subcellular Cytosol | Organelles

Cellular

Nephron/Kidney

Insult

lATP

ER blebbing

TCa2+

Mitochondrial

switching

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