Endothelial injury and dysfunction: Role in the extension phase of acute renal failure

Research output: Contribution to journalArticle

241 Citations (Scopus)

Abstract

The pathophysiology of ischemic acute renal failure (ARF) involves a complex interplay between renal hemodynamics, tubular and endothelial cell injury, and inflammatory processes. A growing body of evidence supports the contribution of altered renal vascular function, especially at the microvascular level, in initiating and subsequently extending the initial tubular injury. The extension phase of ischemic ARF involves continued reduction in renal perfusion, ongoing hypoxia, and inflammatory processes that occur during reperfusion and contribute to continued tubular cell injury. Vascular endothelial cell injury and dysfunction play a vital part in this extension phase. With injury, the endothelial cell loses its ability to regulate vascular tone, perfusion, permeability and inflammation/adhesion. This loss of regulatory function has a detrimental impact upon renal function. Vascular congestion, edema formation, diminished blood flow, and infiltration of inflammatory cells have been documented in the corticomedullary junction of the kidney. However, linking their genesis to microvascular endothelial injury and dysfunction has been difficult. New diagnostic and therapeutic approaches to ischemic ARF must incorporate these finding to devise early recognition strategies and therapeutic approaches.

Original languageEnglish
Pages (from-to)496-499
Number of pages4
JournalKidney International
Volume66
Issue number2
DOIs
StatePublished - Aug 2004

Fingerprint

Acute Kidney Injury
Kidney
Wounds and Injuries
Blood Vessels
Endothelial Cells
Perfusion
Reperfusion
Permeability
Edema
Hemodynamics
Inflammation
Therapeutics

Keywords

  • Acute renal failure
  • Coagulation
  • Endothelium
  • Inflammation
  • Ischemia
  • Kidney disease
  • Vascular

ASJC Scopus subject areas

  • Nephrology

Cite this

Endothelial injury and dysfunction : Role in the extension phase of acute renal failure. / Molitoris, Bruce; Sutton, Timothy.

In: Kidney International, Vol. 66, No. 2, 08.2004, p. 496-499.

Research output: Contribution to journalArticle

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