Abstract

Studying differential cell function or dysfunction within the kidney is made difficult by cellular heterogeneity, alterations in regional blood flow, oxygen tension, and interstitial tonicity, resulting in extremely complex anatomic and physiologic arrangements. Creative investigators have developed techniques to reduce this heterogeneity but often with loss or alteration of three-dimensional cellular associations, anatomic and physiologic cell-to-cell interactions, and harsh isolation and experimental conditions. These limitations have made “absolutes” difficult to determine, especially in relation to pathologic processes such as cell type involvement in renal ischemia. In this issue of JASN , Hall et al. 1 use multiphoton microscopy of kidney slices to compare mitochondrial parameters and differential cellular responses to stress. This approach allows them to quantify several key parameters of mitochondrial function and dysfunction in proximal tubular (PT) cells and directly compare different PT segments with each other and with distal tubular (DT) cells of the thick ascending limb (TAL). Because mitochondrial alterations play a central role in normal cell function and in response to injury, the article adds to our previous knowledge about an important area. To understand the significance and limitations of their contribution, one must first understand what is known about differences between PT and TAL cells. Abundant mitochondria in cortical and outer medullary renal epithelial cells are necessary to meet the ATP demands of sodium transport by high-capacity aerobic metabolism. They compose 33% of the volume of proximal convoluted tubular S1 cells, 39% of the cells in the S2 segment, and 22% of the volume of cells in the proximal straight S3 segment; in the medullary and cortical TAL cells, mitochondria account for 30 to 44% of cell volume.2 Differential tubular cell metabolism is also notable for the absence of aerobic and anaerobic glycolysis in the proximal convoluted tubule (S1), …

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