Tuesday, April 22, 2014

Acute Renal Success

Acute Renal Success


Acute kidney injury used to be called "acute renal failure".  An interesting phenomenon that occurs with damage to the proximal tubule should be called "acute renal success".  Impaired reabsorption of sodium triggers tubuloglomerular feedback due to increased Na+ load to the macula densa.  This, in turn, leads to release of adenosine and vasoconstriction of the afferent arteriole.  The result is decreased GFR and decreased urine formation (oligouria).  This is protective in preventing massive volume loss via excess urine formation.