What are 3 causes of acute tubular epithelial injury?
toxic, ischemic, obstructive
What is the gross appearance of acute infarcts in the kidney?
red, wedge-shaped foci, especially in the cortex
What is important to remember when evaluating any animal for acute kidney injury?
chronic disease can present acutely
What is the basis for why AKI can sometimes be reversible?
--> normal tubule--> proximal tubule simplification: lose their apical brush border--> scattered tubule epithelial cells die and detach--> dead cells/fragments obstruct lumens of distal nephrons-->neighboring cells stretch to cover denuded BM--> normal tubule
What is imperative for AKI to be reversible?
basement membrane must be intact!!
Tubular epithelial cell vacuolation is associated with __________.
Histological lesions of acute kidney injury. (8)
loss of apical brush border, singly dead epithelial cells, fragments of cells in tubules,stretched out simplified cells, congestion, interstitial hemorrhage, acute inflammation, crystals in tubules
If AKI insult is severe and/or prolonged, ___________ may develop.
coagulative and liquefactive necrosis
What are the determinants of the outcome of AKI? (3)
timely removal of inciting cause, maintenance of intact tubular basement membranes, cytokine expression of tubular epithelial cells
Mechanisms of acute tubular epithelial injury? (8)
interference with oxidative phosphorylation, vascular effects, lipid peroxidation, membrane damage, calcium homeostasis, protein synthesis, cytoskeletal toxins, induction of apoptosis
Causes of ischemic acute tubular epithelial injury. (5)