Cell death in toxic nephropathies.

Toxic nephropathies cause acute and chronic renal failure, primarily as a result of injury to renal tubular epithelium. There is a well-known capacity in the renal nephron for the synchronous occurrence of both apoptosis and necrosis in toxic nephropathies. This has engendered interest in the differing or complementary roles of these modes of cell death. Once thought to be mutually exclusive in incidence and morphologic and biochemical features, recent evidence in renal and other diseases indicates some blurring in the features of apoptosis and necrosis, particularly in the situations in which they are identified, in their molecular pathways, and in the role of inflammation in the processes. Definition of the heterogenic pathophysiologic response of the nephron should provide information useful for promoting the health of the kidney after injury, particularly in relation to controlling the extent and modalities of cell death via the associated renal-specific molecular features. This article indicates the significance and some problems of defining the types of cell death in toxic nephropathies.