| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
AJP - Regulatory, Integrative and Comparative Physiology, Vol 273, Issue 1 1-15, Copyright © 1997 by American Physiological Society
ARTICLES |
A. W. Cowley Jr
Department of Physiology, Medical College of Wisconsin, Milwaukee 53226, USA.
The original fascination with the medullary circulation of the kidney was driven by the unique structure of vasa recta capillary circulation, which Berliner and colleagues (Berliner, R. W., N. G. Levinsky, D. G. Davidson, and M. Eden. Am. J. Med. 24: 730-744, 1958) demonstrated could provide the economy of countercurrent exchange to concentrate large volumes of blood filtrate and produce small volumes of concentrated urine. We now believe we have found another equally important function of the renal medullary circulation. The data show that it is indeed the forces defined by Starling 100 years ago that are responsible for the pressure-natriuresis mechanisms through the transmission of changes of renal perfusion pressure to the vasa recta circulation. Despite receiving only 5-10% of the total renal blood flow, increases of blood flow to this region of the kidney cause a washout of the medullary urea gradient and a rise of the renal interstitial fluid pressure. These forces reduce tubular reabsorption of sodium and water, leading to a natriuresis and diuresis. Many of Starling's intrinsic chemicals, which he named "hormones," importantly modulate this pressure-natriuresis response by altering both the sensitivity and range of arterial pressure around which these responses occur. The vasculature of the renal medulla is uniquely sensitive to many of these vasoactive agents. Finally, we have found that the renal medullary circulation can play an important role in determining the level of arterial pressure required to achieve long-term fluid and electrolyte homeostasis by establishing the slope and set point of the pressure-natriuresis relationship. Measurable decreases of blood flow to the renal medulla with imperceptible changes of total renal blood flow can lead to the development of hypertension. Many questions remain, and it is now evident that this is a very complex regulatory system. It appears, however, that the medullary blood flow is a potent determinant of both sodium and water excretion and signals changes in blood volume and arterial pressure to the tubules via the physical forces that Professor Starling so clearly defined 100 years ago.
This article has been cited by other articles:
|
|
 |
|
  J. M. Moreno, I. Rodriguez Gomez, R. Wangensteen, M. Alvarez-Guerra, J. d. D. Luna, J. Garcia-Estan, and F. Vargas Tempol improves renal hemodynamics and pressure natriuresis in hyperthyroid rats Am J Physiol Regulatory Integrative Comp Physiol, March 1, 2008; 294(3): R867 - R873. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Kjolby and P. Bie Chronic activation of plasma renin is log-linearly related to dietary sodium and eliminates natriuresis in response to a pulse change in total body sodium Am J Physiol Regulatory Integrative Comp Physiol, January 1, 2008; 294(1): R17 - R25. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. W. Rajapakse, G. A. Eppel, R. E. Widdop, and R. G. Evans ANG II type 2 receptors and neural control of intrarenal blood flow Am J Physiol Regulatory Integrative Comp Physiol, December 1, 2006; 291(6): R1669 - R1676. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. A. Eppel, S. E. Luff, K. M. Denton, and R. G. Evans Type 1 neuropeptide Y receptors and {alpha}1-adrenoceptors in the neural control of regional renal perfusion Am J Physiol Regulatory Integrative Comp Physiol, February 1, 2006; 290(2): R331 - R340. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. W. Rajapakse, A. K. Sampson, G. A. Eppel, and R. G. Evans Angiotensin II and nitric oxide in neural control of intrarenal blood flow Am J Physiol Regulatory Integrative Comp Physiol, September 1, 2005; 289(3): R745 - R754. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Lee-Kwon, J. B. Wade, Z. Zhang, T. L. Pallone, and E. J. Weinman Expression of TRPC4 channel protein that interacts with NHERF-2 in rat descending vasa recta Am J Physiol Cell Physiol, April 1, 2005; 288(4): C942 - C949. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Zhang, T. Pibulsonggram, and A. Edwards Determinants of basal nitric oxide concentration in the renal medullary microcirculation Am J Physiol Renal Physiol, December 1, 2004; 287(6): F1189 - F1203. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. Zhang and T. L. Pallone Response of descending vasa recta to luminal pressure Am J Physiol Renal Physiol, September 1, 2004; 287(3): F535 - F542. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. W. Rajapakse, R. J. Roman, J. R. Falck, J. J. Oliver, and R. G. Evans Modulation of V1-receptor-mediated renal vasoconstriction by epoxyeicosatrienoic acids Am J Physiol Regulatory Integrative Comp Physiol, July 1, 2004; 287(1): R181 - R187. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. M. Duke, G. A. Eppel, R. E. Widdop, and R. G. Evans Disparate Roles of AT2 Receptors in the Renal Cortical and Medullary Circulations of Anesthetized Rabbits Hypertension, August 1, 2003; 42(2): 200 - 205. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. W. Cowley Jr., T. Mori, D. Mattson, and A.-P. Zou Role of renal NO production in the regulation of medullary blood flow Am J Physiol Regulatory Integrative Comp Physiol, June 1, 2003; 284(6): R1355 - R1369. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Yuan, M. Liang, Z. Yang, E. Rute, N. Taylor, M. Olivier, and A. W. Cowley Jr. Gene expression reveals vulnerability to oxidative stress and interstitial fibrosis of renal outer medulla to nonhypertensive elevations of ANG II Am J Physiol Regulatory Integrative Comp Physiol, May 1, 2003; 284(5): R1219 - R1230. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Rhinehart, C. A. Handelsman, E. P. Silldorff, and T. L. Pallone ANG II AT2 receptor modulates AT1 receptor-mediated descending vasa recta endothelial Ca2+ signaling Am J Physiol Heart Circ Physiol, March 1, 2003; 284(3): H779 - H789. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. L. Pallone, Z. Zhang, and K. Rhinehart Physiology of the renal medullary microcirculation Am J Physiol Renal Physiol, February 1, 2003; 284(2): F253 - F266. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Sarkis, K. L. Liu, M. Lo, and D. Benzoni Angiotensin II and renal medullary blood flow in Lyon rats Am J Physiol Renal Physiol, February 1, 2003; 284(2): F365 - F372. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. L. Mattson Importance of the renal medullary circulation in the control of sodium excretion and blood pressure Am J Physiol Regulatory Integrative Comp Physiol, January 1, 2003; 284(1): R13 - R27. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. A. Eppel, G. Bergstrom, W. P. Anderson, and R. G. Evans Autoregulation of renal medullary blood flow in rabbits Am J Physiol Regulatory Integrative Comp Physiol, January 1, 2003; 284(1): R233 - R244. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S.-J. Guild, G. A. Eppel, S. C. Malpas, N. W. Rajapakse, A. Stewart, and R. G. Evans Regional responsiveness of renal perfusion to activation of the renal nerves Am J Physiol Regulatory Integrative Comp Physiol, November 1, 2002; 283(5): R1177 - R1186. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. Zhang, K. Rhinehart, and T. L. Pallone Membrane potential controls calcium entry into descending vasa recta pericytes Am J Physiol Regulatory Integrative Comp Physiol, October 1, 2002; 283(4): R949 - R957. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Rhinehart, Z. Zhang, and T. L. Pallone Ca2+ signaling and membrane potential in descending vasa recta pericytes and endothelia Am J Physiol Renal Physiol, October 1, 2002; 283(4): F852 - F860. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. Grisk, H.-J. Rose, G. Lorenz, and R. Rettig Sympathetic-renal interaction in chronic arterial pressure control Am J Physiol Regulatory Integrative Comp Physiol, August 1, 2002; 283(2): R441 - R450. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Szentivanyi Jr., A.-P. Zou, D. L. Mattson, P. Soares, C. Moreno, R. J. Roman, and A. W. Cowley Jr. Renal medullary nitric oxide deficit of Dahl S rats enhances hypertensive actions of angiotensin II Am J Physiol Regulatory Integrative Comp Physiol, July 1, 2002; 283(1): R266 - R272. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. P. Basile, D. Donohoe, K. Roethe, and J. L. Osborn Renal ischemic injury results in permanent damage to peritubular capillaries and influences long-term function Am J Physiol Renal Physiol, November 1, 2001; 281(5): F887 - F899. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. Zhang, J. M. C. Huang, M. R. Turner, K. L. Rhinehart, and T. L. Pallone Role of chloride in constriction of descending vasa recta by angiotensin II Am J Physiol Regulatory Integrative Comp Physiol, June 1, 2001; 280(6): R1878 - R1886. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Yuan and A. W. Cowley Jr Evidence That Reduced Renal Medullary Nitric Oxide Synthase Activity of Dahl S Rats Enables Small Elevations of Arginine Vasopressin to Produce Sustained Hypertension Hypertension, February 1, 2001; 37(2): 524 - 528. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. L. Leonard, S. C. Malpas, K. M. Denton, A. C. Madden, and R. G. Evans Differential control of intrarenal blood flow during reflex increases in sympathetic nerve activity Am J Physiol Regulatory Integrative Comp Physiol, January 1, 2001; 280(1): R62 - R68. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. T. Llinas, F. Rodriguez, C. Moreno, and F. J. Salazar Role of cyclooxygenase-2-derived metabolites and nitric oxide in regulating renal function Am J Physiol Regulatory Integrative Comp Physiol, November 1, 2000; 279(5): R1641 - R1646. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. P. Anderson, M. M. Kett, K. M. Stevenson, A. J. Edgley, K. M. Denton, and S. M. Fitzgerald Renovascular Hypertension : Structural Changes in the Renal Vasculature Hypertension, October 1, 2000; 36(4): 648 - 652. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. L. Leonard, R. G. Evans, M. A. Navakatikyan, and S. C. Malpas Differential neural control of intrarenal blood flow Am J Physiol Regulatory Integrative Comp Physiol, September 1, 2000; 279(3): R907 - R916. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. Fang, S. H. Carlson, N. Peng, and J. M. Wyss Circadian rhythm of plasma sodium is disrupted in spontaneously hypertensive rats fed a high-NaCl diet Am J Physiol Regulatory Integrative Comp Physiol, June 1, 2000; 278(6): R1490 - R1495. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A.-M. Teichert, T. L. Miller, S. C. Tai, Y. Wang, X. Bei, G. B. Robb, M. J. Phillips, and P. A. Marsden In vivo expression profile of an endothelial nitric oxide synthase promoter-reporter transgene Am J Physiol Heart Circ Physiol, April 1, 2000; 278(4): H1352 - H1361. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. G. Correia, A. C. Madden, G. Bergstrom, and R. G. Evans Effects of Renal Medullary and Intravenous Norepinephrine on Renal Antihypertensive Function Hypertension, April 1, 2000; 35(4): 965 - 970. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Szentivanyi Jr, F. Park, C. Y. Maeda, and A. W. Cowley Jr Nitric Oxide in the Renal Medulla Protects From Vasopressin-Induced Hypertension Hypertension, March 1, 2000; 35(3): 740 - 745. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. C. F. Sandgaard, J. L. Andersen, and P. Bie Hormonal regulation of renal sodium and water excretion during normotensive sodium loading in conscious dogs Am J Physiol Regulatory Integrative Comp Physiol, January 1, 2000; 278(1): R11 - R18. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Szentivanyi Jr, A.-P. Zou, C. Y. Maeda, D. L. Mattson, and A. W. Cowley Jr Increase in Renal Medullary Nitric Oxide Synthase Activity Protects From Norepinephrine-Induced Hypertension Hypertension, January 1, 2000; 35(1): 418 - 423. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. MERVAALA, B. DEHMEL, V. GROSS, A. LIPPOLDT, J. BOHLENDER, A. F. MILIA, D. GANTEN, and F. C. LUFT Angiotensin-Converting Enzyme Inhibition and AT1 Receptor Blockade Modify the Pressure-Natriuresis Relationship by Additive Mechanisms in Rats with Human Renin and Angiotensinogen Genes J. Am. Soc. Nephrol., August 1, 1999; 10(8): 1669 - 1680. [Abstract] [Full Text]
|
|
|
|
|
|
A. G. Correia, G. Bergstrom, A. J. Lawrence, and R. G. Evans Renal medullary interstitial infusion of norepinephrine in anesthetized rabbits: methodological considerations Am J Physiol Regulatory Integrative Comp Physiol, July 1, 1999; 277(1): R112 - R122. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Szentivanyi Jr, C. Y. Maeda, and A. W. Cowley Jr Local Renal Medullary L-NAME Infusion Enhances the Effect of Long-Term Angiotensin II Treatment Hypertension, January 1, 1999; 33(1): 440 - 445. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Miyata and A. W. Cowley Jr Renal Intramedullary Infusion of L-Arginine Prevents Reduction of Medullary Blood Flow and Hypertension in Dahl Salt-Sensitive Rats Hypertension, January 1, 1999; 33(1): 446 - 450. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. W. Cowley Jr., M. M. Skelton, and T. M. Kurth Effects of long-term vasopressin receptor stimulation on medullary blood flow and arterial pressure Am J Physiol Regulatory Integrative Comp Physiol, November 1, 1998; 275(5): R1420 - R1424. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Gross, T. M. Kurth, M. M. Skelton, D. L. Mattson, and A. W. Cowley Jr. Effects of daily sodium intake and ANG II on cortical and medullary renal blood flow in conscious rats Am J Physiol Regulatory Integrative Comp Physiol, May 1, 1998; 274(5): R1317 - R1323. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. L. Pallone and J. M.-C. Huang Control of descending vasa recta pericyte membrane potential by angiotensin II Am J Physiol Renal Physiol, June 1, 2002; 282(6): F1064 - F1074. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Liang, B. Yuan, E. Rute, A. S. Greene, A.-P. Zou, P. Soares, G. D. MCQuestion, G. R. Slocum, H. J. Jacob, and A. W. Cowley Jr. Renal medullary genes in salt-sensitive hypertension: a chromosomal substitution and cDNA microarray study Physiol Genomics, February 28, 2002; 8(2): 139 - 149. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Visit Other APS Journals Online |
