Fig. 6From: Urinary metabolites predict mortality or need for renal replacement therapy after combat injurySimplified pathway of lactic acid fermentation. This anaerobic metabolism occurs when there is not enough oxygen to run the TCA cycle and oxidative phosphorylation. Glycolysis converts glucose to pyruvate, producing ATP and NADH. Pyruvate makes lactate instead of going into the TCA cycle. This reaction produces NAD+ from NADH. Adapted from Reference [30]Back to article page