For more than 15 years, there has been an ongoing debate regarding the nephron segment
(s) most severely injured in acute renal failure (ARF) induced by an ischemic or toxic insult.
Although 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 discussion, the first of three on different aspects of …

Acute renal failure (ARF) in the critical care setting is defined as the abrupt decline in
glomerular filtration rate (GFR) resulting from ischemic or toxic injury to the kidney. ARF is
often only one of several organ-system failures that are present in this patient population.
Recent evidence suggests that there are four major factors that are the most important in the
initiation and maintenance of ARF. These include a decrease of glomerular capillary
permeability, back-leak of glomerular filtrate, tubular obstruction, and intrarenal …

This review, which is the final installment in a series devoted to controversial issues in acute
renal failure (ARF)(3, 47), will examine available information regarding the role of growth
factors in ARF. In general, studies in this area have fallen into two broad categories: 1) those
that have examined the renal expression of genes encoding growth factors or transcriptional
factors associated with the growth response that is induced after ARF, and 2) those that have
examined the efficacy of exogenously administered growth factors in accelerating recovery …