ABSTRACT
This chapter focuses on the cellular and molecular consequences of ischemia in the kidney. The damaged cells sluff leaving a denuded basement membrane. Inhibition of cellular metabolism results in depletion of adenosine triphosphate (ATP) and loss of the energy reserve necessary to energize membrane transporters which drive transmembrane electrolyte movement and maintain the internal electrolyte content of the cell. Cell swelling has very different consequences in an isolated cell when compared to an organ. Cellular levels of ATP fall with oxygen deprivation in tubular cells that normally generate their energy currency as a result of aerobic metabolism. Many cellular processes are critically dependent upon ATP hydrolysis. Calcium is critical to cellular function. It is involved in the regulation of contraction, mobility, secretion, membrane stability, cell division, phagocytosis, and many enzymatic processes. Reactive oxygen species have been implicated in various forms of cellular injury, including ischemic insults.
