A 33-year-old woman has had increasing lethargy and decreased urine output for the past week. Laboratory studies show her serum creatinine is 4.3 mg/ dL and urea nitrogen 40 mg/dL. A renal biopsy is performed, and the specimen is examined using electron microscopy. Which of the following morphologic cellular changes most likely suggests a diagnosis of acute tubular necrosis?
Cell death occurs with loss of the cell nucleus, and tubular cells become necrotic. All other cellular morphologic changes listed represent forms of reversible cellular injury. The plasma membrane and intracellular organelles retain some function unless severe damage causes loss of membrane integrity.
Chromatin clumping
Mitochondrial swelling
Nuclear fragmentation
Plasma membrane blebs
Cellular Pathology