Osmotic nephrosis: acute kidney injury with accumulation of proximal tubular lysosomes due to administration of exogenous solutes

Am J Kidney Dis. 2008 Mar;51(3):491-503. doi: 10.1053/j.ajkd.2007.10.044.

Abstract

Osmotic nephrosis describes a morphological pattern with vacuolization and swelling of the renal proximal tubular cells. The term refers to a nonspecific histopathologic finding rather than defining a specific entity. Osmotic nephrosis can be induced by many different compounds, such as sucrose, hydroxyethyl starch, dextrans, and contrast media. It has a broad clinical spectrum that includes acute kidney injury and chronic kidney failure in rare cases. This article discusses the pathological characteristics, pathogenesis, and various clinical entities of osmotic nephrosis.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury / chemically induced*
  • Acute Kidney Injury / pathology*
  • Animals
  • Anticoagulants / adverse effects*
  • Dextrans / adverse effects
  • Diagnosis, Differential
  • Diuretics, Osmotic / adverse effects
  • Epithelial Cells / pathology
  • Humans
  • Hydroxyethyl Starch Derivatives
  • Immunoglobulins, Intravenous / adverse effects*
  • Immunoglobulins, Intravenous / chemistry
  • Kidney / physiopathology
  • Kidney Glomerulus / pathology
  • Kidney Tubules, Proximal / pathology*
  • Lysosomes / pathology*
  • Mannitol / adverse effects
  • Nephrosis / chemically induced
  • Nephrosis / pathology*
  • Nephrosis / physiopathology
  • Osmotic Pressure
  • Recovery of Function
  • Risk Factors
  • Vacuoles / pathology*

Substances

  • Anticoagulants
  • Dextrans
  • Diuretics, Osmotic
  • Hydroxyethyl Starch Derivatives
  • Immunoglobulins, Intravenous
  • Mannitol