Acute renal failure: definitions, diagnosis, pathogenesis, and therapy
J. Clin. Invest. Robert W. Schrier, et al. 114:5 doi:10.1172/JCI22353 [Go to this article.]

Figure 7
Hypoxic/ischemic proximal tubular necrosis results in activation of cysteine protease pathways involving calpains and both caspase-1 (an inflammatory caspase) and caspase-3 (an executioner caspase involved in apoptosis). Calpain is activated both by increased free cytosolic Ca²⁺ and decreased calpastatin. Calpain then activates caspase-1, which stimulates the inflammatory cytokine IL-18. The executioner caspase-3 cleaves calpastatin (40).