Advertisement

Pathology of Acute Renal Failure

  • Jeffrey I. Kreisberg
  • Erve G. J. Matthys
  • Manjeri A. Venkatachalam

Abstract

Acute renal failure (ARF) can be defined as an abrupt decline in renal function sufficient to result in retention of nitrogenous waste. In this chapter we will describe and discuss, with an emphasis on structure-function correlations, a major subset of the clinical syndrome of ARF, that is, acute tubular necrosis (ATN). By definition, the term ATN includes all forms of acute urinary suppression in which tubular injury of acute onset is the primary basis for renal failure, and excludes all other causes of ARF, such as pre-renal azotemia, interstitial nephritis, glomerulonephritis, disseminated intravascular coagulation with renal cortical necrosis, organic vascular disease, and obstruction of the lower urinary tract (Robbins and Cotran, 1979).

Keywords

Acute Renal Failure Proximal Tubule Mercuric Chloride Acute Tubular Necrosis Proximal Tubule Cell 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Anderson, R. J., and Schrier, R. W., 1980, Clinical spectrum of oliguric and nonoliguric renal failure, in: Contemporary Issues in Nephrology, Acute Renal Failure, (B. M. Brenner and J. H. Stein, eds.), vol. 6, pp. 1–17, Churchill Livingston, New York.Google Scholar
  2. Anderson, R. J., Linas, S. L., Berns, A. S., Henrich, W. L., Miller, T. R., Gabow, P. A., and Schrier, R. W., 1977, Nonoliguric acute renal failure, N. Engl. J. Med. 296:1134.CrossRefGoogle Scholar
  3. Ansari, R. M., and Baldwin, D. S., 1976, Acute renal failure due to radiocontrast agents, Nephron 17:28.CrossRefGoogle Scholar
  4. Arendshorst, W. J., Finn, W. F., and Gottschalk, C. W., 1975, Pathogenesis of acute renal failure following temporary renal ischemia in the rat, Circ. Res. 37:558.CrossRefGoogle Scholar
  5. Arendshorst, W. J., Finn, W. F., and Gottschalk, C. W., 1976, Micropuncture study of acute renal failure following temporary renal ischemia in the rat, Kidney Int. 10:S100.Google Scholar
  6. Avasthi, P. S., Huser, J., and Evan, A. P., 1979, Glomerular endothelial cells in gentamicin induced acute renal failure in rats, Kidney Int. 16:771.Google Scholar
  7. Bank, N., Mutz, B. R., and Aynedjian, H. S., 1967, The role of “leakage” of tubular fluid in anuria due to mercury poisoning, J. Clin. Invest. 46:695.CrossRefGoogle Scholar
  8. Barnes, J. L., Osgood, R. W., Reineck, H. J., and Stein, J. H., 1981, Glomerular alterations in an ischemic model of acute renal failure, Lab. Invest. 45:378.Google Scholar
  9. Biber, T. U. L., Mylle, M., Baines, A. D., Gottschalk, C. W., Oliver, J. R., and MacDowell, M. C., 1968, A study by micropuncture and microdissection of acute renal damage in rats, Am. J. Med. 44:684.CrossRefGoogle Scholar
  10. Blantz, R. C.,and Konnen, K., 1975, The mechanisms of acute renal failure after uranyl nitrate, J. Clin. Invest. 55:621.Google Scholar
  11. Bohle, A., Jahnecke, J., Meyer, D., and Schubert, G. E., 1976, Morphology of acute renal failure: Comparative data from biopsy and autopsy, Kidney Int. 10:S9.Google Scholar
  12. Borisy, G. G., and Olmsted, J. B., 1972, Nucleated assembly of microtubules in porcine brain extracts, Science 177:1196.CrossRefGoogle Scholar
  13. Bushinsky, D. A., Wish, J. B., Hou, S. H., Cohen, J. I., and Harrington, J. T., 1979, Hospital acquired renal insufficiency (1978–1979), Proc. Am. Soc. Nephrol. 12:105A.Google Scholar
  14. Carroll, R., Kavacs, K. and Tapp, E., 1965, The pathogenesis of glycerol induced renal tubular necrosis, J. Pathol. Bacteriol. 89:573.CrossRefGoogle Scholar
  15. Carvallo, A., Rakowsky, T. A., Argy, W. P., Jr., and Schreiner, G. E., 1978, Acute renal failure following drug infusion pyelography, Am. J. Med. 65:38.CrossRefGoogle Scholar
  16. Condeelis, J. S., and Taylor, D. L., 1977, The contractile basis of ameboid movement. V. The control of gelation, solation, and contraction in extracts from Dictyostelium discoideum, J. Cell Biol. 74:901.CrossRefGoogle Scholar
  17. Cox, J. W., Baehler, R. W., Sharma, H., O’Dorisio, T., Osgood, R. W., Stein, J. H., and Ferris, T. F., 1974, Studies on the mechanism of oliguria in a model of acute renal failure: Functional and histological correlates of protection, Kidney Int. 14:115.Google Scholar
  18. Cronin, R. E., 1978, Aminoglycoside nephrotoxicity: Pathogenesis and prevention, Clin. Nephrol. 11:251.Google Scholar
  19. Cronin, R. E., DeTorrente, A., Miller, P. D., Bulger, R. E., Burke, T. J., and Schrier, R. W., 1978, Pathogenetic mechanisms in early norepinephrine-induced acute renal failure: Functional and histological correlates of protection, Kidney Int. 14:115.CrossRefGoogle Scholar
  20. Cuppage, F. E., and Tate, A., 1967, Repair of the nephron following injury with mercuric chloride, Lab. Invest. 26:122.Google Scholar
  21. Cuppage, F. E., Chiga, M., and Tate, A., 1972, Cell cycle studies in the regenerating rat nephron following injury with mercuric chloride, Lab. Invest. 16:122.Google Scholar
  22. Dach, J. L., and Kurtzman, N. A., 1976, A scanning electron microscopic study of the glycerol model of acute renal failure, Lab. Invest. 34:409.Google Scholar
  23. Dobyan, D. C., Nagle, R. B., and Bulger, R. E., 1977, Acute tubular necrosis in the rat kidney following sustained hypotension, Lab. Invest. 37:411.CrossRefGoogle Scholar
  24. Donohoe, J. F., Venkatachalam, M. A., Bernard, D. B., and Levinsky, N. G., 1978, Tubular leakage and obstruction in acute ischemic renal failure, Kidney Int. 13:208.CrossRefGoogle Scholar
  25. Finckh, E. S., 1957, Experimental acute tubular necrosis following subcutaneous injection of glycerol, J. Pathol. Bacteriol. 73:69.CrossRefGoogle Scholar
  26. Flamenbaum, W., McNeil, J. S., Kotchen, T. A., and Saladino, A. J., 1972, Experimental acute renal failure induced by uranyl nitrate in the dog, Circ. Res. 31:682.CrossRefGoogle Scholar
  27. Flamenbaum, W., Hamburger, R. J., Huddleston, M. L., Kaufman, J., McNeil, J. S., Schwartz, J. H., and Nagle, R., 1976, The initiation phase of experimental acute renal failure: An evaluation of uranyl nitrate-induced acute renal failure in the rat, Kidney Int. 10:S115.Google Scholar
  28. Flores, J., DiBona, D. R., Beck, C. H., and Leaf, A., 1972, The role of cell swelling in ischemic renal damage and the protective effect of hypertonic solute, J. Clin. Invest. 51:118.CrossRefGoogle Scholar
  29. Frega, N. S., DiBona, D. R., and Leaf, A., 1979, The protection of renal function from ischemic injury in the rat, Pfluegers Arch. 381:159.CrossRefGoogle Scholar
  30. Ganote, C. E., Reimer, K. A., and Jennings, R. B., 1974, Acute mercuric chloride nephrotoxicity, Lab. Invest. 31:633.Google Scholar
  31. Gritzka, T. L., and Trump, B. F., 1968, Renal tubular lesions caused by mercuric chloride. Electron microscopic observations: Degeneration of the pars recta, Am. J. Pathol. 52:1225.Google Scholar
  32. Hanley, M. J., 1980, Isolation of nephron segments in a rabbit model of ischemic acute renal failure, Am. J. Physiol. 239:F17.Google Scholar
  33. Heptinstall, R. H., 1974, Pathology of the Kidney, 2nd ed., Little, Brown and Co., Boston, Massachusetts.Google Scholar
  34. Hoyer, J. R., and Seiler, M. W., 1979, Pathophysiology of Tamm-Horsfall protein, Kidney Int. 16:479.CrossRefGoogle Scholar
  35. Kant, K. S., Pesce, A.J., Clyne, D. H., and Pollak, V. E., 1976, Urinary cast formation: pH dependence and interaction of Tamm-Horsfall mucoprotein with myoglobin, hemoglobin, Bence-Jones protein and albumin, Kidney Int. 10:559.Google Scholar
  36. Keihart, D. P., and Inoue, S., 1976, Local depolymerization of spindle microtubules by microinjection of calcium ions, J. Cell Biol. 70:230a.Google Scholar
  37. Kreisberg, J. I., Bulger, R. E., Trump, G. F., and Nagle, R. B., 1976, Effects of transient hypotension on the structure and function of rat kidney, Virchows Arch. Pathol. 22:121.Google Scholar
  38. Kreisberg, J. I., Mills, J. W., Jarrell, J. A., Rabito, C. A., and Leaf, A., 1980, Protection of cultured renal tubular epithelial cells from anoxic swelling and cell death, Proc. Natl. Acad. Sci. USA 77:5445.CrossRefGoogle Scholar
  39. Kriz, W., 1962, Histophysiologische Untersunchungen en der Rattenniere bei Sublimatvergiftung, Z. Zellforsch. 57:914.Google Scholar
  40. Leaf, A., 1956, On the mechanism of fluid exchange of tissue in vitro, Biochem. J. 62:241.Google Scholar
  41. McQueen, E. G., 1962, The nature of urinary casts, J. Clin. Path. 15:367.CrossRefGoogle Scholar
  42. Miller, T. R., Anderson, R. J., Linas, S. L., Henrich, W. L., Berns, A. S., Gabow, P. A., and Schrier, R. W., 1978, Urinary diagnostic indices in acute renal failure. A prospective study, Ann. Intern. Med. 89:47.Google Scholar
  43. Oliver, J., 1915, The histogenesis of chronic uranium nephritis with special reference to epithelial regeneration, J. Exp. Med. 21:425.CrossRefGoogle Scholar
  44. Oliver, J., MacDowell, M., and Tracy, A., 1951, The pathogenesis of acute renal failure associated with traumatic and toxic injury. Renal ischemia, nephrotoxic damage and the ischemuric episode, J. Clin. Invest. 30:1305.CrossRefGoogle Scholar
  45. Olsen, S., 1976, Renal histopathology in various forms of acute anuria in man, Kidney Int. 10:S2.Google Scholar
  46. Porter, G. A., and Bennett, W. M., 1980, Nephrotoxin-induced acute renal failure, in: Contemporary issues in Nephrology, Volume 6, Acute Renal Failure (B. M. Brenner and J. H. Stein, eds.), Churchill Livingston, New York, p. 123.Google Scholar
  47. Reineck, H. S., O’Connor, G. I., Lifschitz, M., and Stein, J. H., 1980, Sequential studies on the pathophysiology of glycerol-induced renal failure, J. Lab. Clin. Med. 96:356.Google Scholar
  48. Robbins, S. L., and Cotran, R. S., 1979, Pathologic Basis of Disease, 2nd ed., Saunders, Philadelphia, Pennsylvania, p. 1149.Google Scholar
  49. Robinson, J. R., 1971, Control of water content of non-metabolizing kidney slices of sodium chloride and polyethylene glycol (PEG 6000), J. Physiol. (Lond.) 213:227.Google Scholar
  50. Schanne, F. A. X., Kane, A. B., Young, E. E., and Farber, J. L., 1979, Calcium dependence of toxic cell death: A final common pathway, Science 206:700.CrossRefGoogle Scholar
  51. Schreiner, G. E., and Maher, J. F., 1965, Toxic nephropathy, Am. J. Med. 38:409.CrossRefGoogle Scholar
  52. Smolens, P., and Stein, J. H., 1980, Hemodynamic factors in acute renal failure: Pathophysiologic and therapeutic implications, in: Contemporary Issues in Nephrology, Volume 6, Acute Renal Failure (B. M. Brenner and J. H. Stein, eds.), Churchill Livingston, New York, p. 180.Google Scholar
  53. Smolens, P., and Stein, J. H., 1981, Pathophysiology of acute renal failure, Am. J. Med. 70:479.CrossRefGoogle Scholar
  54. Smolens, P., Reineck, H. J., Venkatachalam, M., and Stein, J. H., 1981, Studies on the pathogenesis of renal failure in a rat model of multiple myeloma, Kidney Int. 19:214A.Google Scholar
  55. Solez, K., Altman, J., Reinhoff, H. Y., Riela, A. F., Finer, P. M., and Heptinstall, R. H., 1976, Early angiographic and renal blood flow changes after HgCl2 or glycerol administration, Kidney Int. 10:S153.Google Scholar
  56. Solez, K., Morel-Maroger, L., and Sraer, J. D., 1979, The morphology of “acute tubular necrosis” in man: Analysis of 57 renal biopsies and a comparison with the glycerol model, Medicine 58:362.CrossRefGoogle Scholar
  57. Stein, J. H., Gottschalk, J., Osgood, R. W., and Ferris, T. F., 1975, Pathophysiology of a nephrotoxic model of acute renal failure, Kidney Int. 8:27.CrossRefGoogle Scholar
  58. Steinhausen, M., Eisenbach, G.-M., and Helmstadter, V., 1969, Concentration of lissamine green in proximal tubules of antidiuretic and mercury poisoned rats and the permeability of these tubules, Pfluegers Arch. 311:1.CrossRefGoogle Scholar
  59. Summers, W. K., and Jamison, R. L., 1971, The no reflow phenomenon in renal ischemia, Lab. Invest. 25:635.Google Scholar
  60. Suzuki, T., and Mostofi, F. K., 1970a, Electron microscopic studies of acute tubular necrosis. Early changes in the glomeruli of rat kidney after subcutaneous injection of glycerin, Lab. Invest. 23:8.Google Scholar
  61. Suzuki, T., and Mostofi, F. K., 1970b, Electron microscopic studies of acute renal necrosis. Vascular changes in the rat kidney after subcutaneous injection of glycerin, Lab. Invest. 23:29.Google Scholar
  62. Swartz, R. D., Rubin, J. E., Leeming, B. W., and Silva, P., 1978, Amphotericin B nephrotoxicity with irreversible renal failure, Ann. Intern. Med. 59:716.Google Scholar
  63. Tanner, G. A., and Sophasan, S., 1976, Kidney pressures after temporary renal artery occlusion in the rat, Am. J. Physiol. 230:1173.Google Scholar
  64. Thiel, G., Wilson, D. R., Arce, M. L., and Oken, D. E., 1967, Glycerol-induced hemoglobinuric acid renal failure in the rat. II. The experimental model, predisposing factors, and pathophysiologic features, Nephron 4:175.CrossRefGoogle Scholar
  65. Venkatachalam, M. A., Rennke, H. G., and Sandstrom, D. J., 1976, The vascular basis for acute renal failure in the rat: Preglomerular and postglomerular vasoconstriction. Circ. Res. 38:267.CrossRefGoogle Scholar
  66. Venkatachalam, M. A., Bernard, D. B., Donohoe, J. F., and Levinsky, N. G., 1978, Ischemic damage and repair in the rat proximal tubule. Differences among the S1, S2, and S3 segments. Kidney Int. 14:31.CrossRefGoogle Scholar
  67. Wardle, E. N., and Wright, N. A., 1973, Intravascular coagulation and glycerin hemoglobinuric acute renal failure, Arch. Pathol. Lab. Med. 95:271.Google Scholar
  68. Wiggins, P. M., 1964, Selective accumulation of potassium ion gel and kidney slices, Biochim. Biophys. Acta 88:593.Google Scholar
  69. Zimmerman, H. D., Schmidt, E., Weiler, E., Becker, C., and Dicken, P., 1977, Intra and extrarenal vascular changes in the acute renal failure of the rat caused by mercuric chloride, Virchows Arch. Pathol Anat. 372:259.Google Scholar

Copyright information

© Springer Science+Business Media New York 1982

Authors and Affiliations

  • Jeffrey I. Kreisberg
    • 1
  • Erve G. J. Matthys
    • 1
  • Manjeri A. Venkatachalam
    • 1
  1. 1.Departments of Pathology and MedicineUniversity of Texas Health Science Center at San AntonioSan AntonioUSA

Personalised recommendations