AKI Trajectory | Lecture Note - Edubirdie

University:
The University Of Western Ontario
Course:
Pathology 3500B | Human Pathology
Academic year:

2023
Views:

178

Pages:

3
Author:

Kyuwon J.

AKI trajectory ● Adaptive repair ⇒ Full recovery ○ Tubular epithelial cell survival ■ Dedifferentiation ■ Proliferations ■ Redifferentiate ● Mature tubular cells ○ Restoring… ■ Tubular polarity ■ Brush border ■ Mitochondrial activity ● HIST ○ Small residual damages ○ Intact basement membranes ○ No interstitial fibrosis ● A ○ ○ ○ ○ ○ ○ Tubules round and outlined Lining intact Patterns of lumina are regular Basement membrane continuous No expansion of interstitials Therefore normal repair ○ ○ ○ ○ Tubular swelling Brush border loss Lumina irregular Debris within tubules ● B ○ Interstitial edema ○ Acute tubular injury ■ Could be reversible until this point ■ Only if the basement membrane is still intact ■ Could be seen in nephorotoxic AKI ● C ○ ○ ○ ○ ○ Flattened, basophilic epithelial cells Nuclear-to-cytoplams ratio Immature Basement still intact Active tubular regen ■ Recovery phase of ATN ● D ○ Glomerulus intact ○ Surrounded by… ■ Architecture preserved ■ No collapse ■ No dropout ○ No fibrosis/scarring ○ Structural preservations ■ Near full functional recovery possible Creatine as late markers ● Reflects function not the injury ● Rises ⇒ significant nephron damages ● Injury occurred already in the pink zones ○ NGAL ○ KLM-1 ○ IL-18 ○ TIMP-2/IGFBP-7 ● Prior to the rise of creatinine, during pink AKI windows

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