Importance of the renal medullary circulation in the control of sodium excretion and blood pressure

Research output: Contribution to journalReview article

108 Scopus citations

Abstract

The control of renal medullary perfusion and the impact of alterations in medullary blood flow on renal function have been topics of research interest for almost four decades. Many studies have examined the vascular architecture of the renal medulla, the factors that regulate renal medullary blood flow, and the influence of medullary perfusion on sodium and water excretion and arterial pressure. Despite these studies, there are still a number of important unanswered questions in regard to the control of medullary perfusion and the influence of medullary blood flow on renal excretory function and blood pressure. This review will first address the vascular architecture of the renal medulla and the potential mechanisms whereby medullary perfusion may be regulated. The known extrarenal and local systems that influence the medullary vasculature will then be summarized. Finally, this review will present an overview of the evidence supporting the concept that selective changes in medullary perfusion can have a potent influence on sodium and water excretion with a long-term influence on arterial blood pressure regulation.

Original languageEnglish (US)
Pages (from-to)R13-R27
JournalAmerican Journal of Physiology - Regulatory Integrative and Comparative Physiology
Volume284
Issue number1 53-1
DOIs
StatePublished - Jan 1 2003
Externally publishedYes

Keywords

  • Hypertension
  • Kidney
  • Renal hemodynamics
  • Renal medullary blood flow

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)

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