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The proximal tubule is the primary site of reabsorption of water and electrolytes, particularly sodium. Haemodynamically acute renal failure is mediated by severe intravascular volume deficit and/or endotoxaemia in horses with strangulation obstruction. Destruction of the epithelium of the proximal tubule decreases one of the major functions of the kidney. The damage to the epithelium of the proximal tubule was demonstrated by collecting kidneys of 9 horses. Six horses had strangulation obstruction, three were normal. An exact representation of the fine structures of the individual sections of the nephron could be obtained on the basis of light and electron microscopy. Distention of the proximal tubule, increased numbers of endocytotic apical vacuoles, increase of size, loss of the brush border of the epithelial cells of the proximal tubule, areas of disseminated intravascular thrombi and interstitial oedema were seen under light microscopy. Apical blebs and luminal casts were significantly evident upon scanning electron microscopy. Cell necrosis and isolated epithelial cells in the tubular lumen were detected by transmission electron microscopic study. In all colic horses the GGT/Creatine ratio was markedly increased and correlated with the morphological changes in the proximal tubule. Encymuria and morphological changes of the proximal tubule are signs of acute renal failure in these horses with colic, the condition of which was mediated haemodynamically by marked haemoconcentration