Các phân tử này có khả năng tổn thương mô thận trong cùng một cách thức mà họ ảnh hưởng đến gan. Họ được cho là được kích hoạt bằng oxidases cytochrome P450 sản xuất các gốc tự do mà sau đó có thể tấn công các cơ quan tế bào tế bào chẳng hạn như màng tế bào. | Halogenated Hydrocarbons These molecules are likely to damage kidney tissue in the same manner in which they affect the liver. They are thought to be activated by cytochrome P450 oxidases producing free radicals which can then attack cell organelles such as cell membranes. Halogenated hydrocarbons like chloroform may covalently bind renal tubular cell proteins and thereby disrupt the normal activity of those proteins. Analgesics Aspirin and phenacetin damage the medulla the inner structure of the kidney where many of the loops and collecting ducts are located. They also affect the blood vessels which may be the reason the medulla is secondarily affected. In other words aspirin inhibits prostaglandin synthesis thus reducing vasodilation with an eventual effect on kidney function. assessment of kidney injury BY biochemical testing The kidney s ability to filter blood depends primarily on the health of the nephron and within the nephron on the integrity of the glomerulus. Glomerular filtration therefore is the best index of filtering ability. The best measure of filtration in turn is clearance . the removal of waste chemicals from blood per unit time. Good renal function equals the ability to clear waste chemicals effectively from the blood. Clearance is expressed in units of milliliters per minute and equals the volume of blood that is cleared per minute. A normal result in humans is approximately 120 mL min. Individuals with serious impairment may have clearances of only 20 mL min or less. These figures are based on the clearance of creatinine a waste product of muscle metabolism. Of various chemicals that have been tested as candidates for determining the glomerular filtration rate creatinine is regarded as the best chemical to measure. It is not perfect because some creatinine is transferred to the urine by tubular secretion and therefore it is not strictly accurate to regard all urinary creatinine as being due to glomerular filtration. Nevertheless creatinine
