The relative importance of proximal versus distal tubular injury in
acute renal failure.
Lieberthal, Wilfred, and Sanjay K. Nigam.
Medical Services, Department of Medicine, Massachusetts General
Hospital, Harvard Medical School and Harvard-Massachusetts Institute
of Technology, Division of Health Sciences Technology, Boston, MA
APStracts 5:0137F, 1998.
For more than fifteen years there has been an ongoing debate regarding
the nephron segment/s that are most severely injured in acute renal
failure (ARF) induced by an ischemic or toxic insult. While some
investigators have argued that the proximal tubule (and particularly
the S3 segment) is the major target of injury in ARF, others have
held the view that damage to the distal nephron [particularly the
medullary thick ascending limb (mTAL) segment] plays a more important
role in this disease. In this review, the first of three on different
aspects of acute renal failure that have been hotly debated, we have
invited several experts to discuss their opinions on this issue. The
goals of this first review (and the subsequent two reviews) are to
establish areas of consensus in each area of controversy, and also to
identify unanswered questions that represent important areas for
future research.
Received 6 June 1998; accepted in final form 27 July 1998.
APS Manuscript Number F183-8.
Article publication pending Am. J. Physiol. (Renal Physiology).
ISSN 1080-4757 Copyright 1998 The American Physiological Society.
Published in APStracts on 21 September 1998