How is pathogenesis of ATI?

➢ Proximal tubular epithelial cells are particularly sensitive to hypoxemia and also are vulnerable to toxins ➢ Ischemia causes numerous structural alterations in epithelial cells. ➢ Injury to the epithelial cells causes detachment of the damaged cells from the basement membranes. ➢ Necrotic tubular cells also may elicit an inflammatory reaction that contributes to the tubular injury ➢ The patchiness of tubular necrosis and maintenance of the integrity of the basement membrane along many segments allow repair of the injured foci and recovery of function if the precipitating cause is removed