Metabolic adaptations of the nephron in renal disease

Morphological and physiological studies have shown that various nephron segments are different functionally and metabolically. Major advances to understand renal metabolism have required improved techniques to study the problem of tissue heterogeneity in the kidney. The degree of heterogeneity within the kidney in renal disease may increase because pathological processes are many times focal or they produce histological changes in certain areas and adaptive changes in other zones of the kidney. Hence, methodological problems have hampered the studies of renal metabolism, particularly at the nephron level, in kidney diseases. Most metabolic studies have been done in experimental animal models of renal disease. This article provides an overview of changes in renal metabolism that occur in urinary tract obstruction, nephrotoxic or ischemic-induced acute renal failure, and in chronic models of reduced renal mass. The information available is limited and the existence of major gaps in our understanding of renal metabolism in diseases of the kidney is evident