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. Author manuscript; available in PMC: 2014 Feb 10.
Published in final edited form as: Compr Physiol. 2012 Apr;2(2):1303–1353. doi: 10.1002/cphy.c110041

Figure 1. Relationship between the clinical phases and the cellular phases of ischemic acute kidney injury (AKI), and the temporal impact on organ function as represented by glomerular filtration rate (GFR).

Figure 1

Prerenal azotemia exists when a reduction in renal blood flow causes a reduction in GFR. A variety of cellular and vascular adaptations maintain renal epithelial integrity during this phases. The initiation phase ossuces when a further reduction in renal blood flow results in cellular injury, particularly the renal tubular epithelial cells, and a continued decline in GFR. Vascular and inflammatory processes that contribute to further cell injury and a further decline in GFR usher in the extension phase. During the maintenance phase, GFR reaches a stable nadir as cellular repair processes are initiated in order to maintain and re-establish organ integrity. The recovery phases in marked by a return of normal cell and organ function than results in an improvement in GFR. Adapted from (532).