EMERGING THERAPIES FOR ACUTE-RENAL-FAILURE

Ischemia is the most common cause of acute renal failure (ARF). In the last decade, several new and important pathophysiological mechanisms that underlie the renal dysfunction have been discovered. These pathop hysiological mechanisms include the role of both calcium and calcium-d ependent enzymes, oxidant stress, loss of polarity of the tubular cell , tubular obstruction and arginine-glycine-aspartic acid (RGD) peptide s, neutrophils, intracellular adhesion molecules (ICAM), and growth fa ctors, A better understanding of tubular and vascular mechanisms has l ed to therapeutic studies in animals and clinical trials in humans. In this review, the pathophysiology of ischemic ARF will be correlated w ith the rationale for both current and future therapies. (C) 1997 by t he National Kidney Foundation, Inc.