Morphological changes and alterations in regional intrarenal blood flow induced by graded renal ischemia.
A model of renal ischemia was used to study morphological changes and alterations in intrarenal blood flow. Renal artery blood flow was reduced from 120 to 20 ml./minute (normal 172 +/- 14) for 3 weeks. Morphological changes were assessed histologically, and by electronmicroscopy. Intrarenal blood flow was determined using microspheres. Flow rates less than 80 ml./minute resulted in a progressive loss of renal volume with arterial thrombosis and renal infarction at 20 ml./minute. Histological changes included loss of glomerular volume, tubular dilatation (60 ml./minute), tubular cast formation (50 ml./minute) tubular atrophy, interstitial fibrosis, arteriolar thickening (40 ml./minute) and glomerular hyalinization (30 ml./minute). Electronmicroscopy changes at 60 ml./minute (loss of glomerular microvasculature, unfolding of glomerular vascular tuft, appearance of blind ending vessels) progressed to disruption of glomerular architecture noted at 30 ml./minute. Narrowing of medullary blood vessels (60 ml./minute) and neovascularisation (40 ml./minute) was observed. Progressive ischemia decreased medullary, inner cortical and outer cortical blood flow (5.9 to 2.1 ml./minute/gm.) p less than 0.01, with a compensatory increase to the opposite kidney.
Moran
K
K
Department of Surgery, University College Dublin, Ireland.
Mulhall
J
J
Kelly
D
D
Sheehan
S
S
Dowsett
J
J
Dervan
P
P
Fitzpatrick
J M
JM
D000818:Animals; D001783:Blood Flow Velocity; D005260:Female; D007511:Ischemia / Q000473:pathology* / Q000503:physiopathology; D007668:Kidney / Q000098:blood supply* / Q000473:pathology*; D007678:Kidney Glomerulus / Q000473:pathology; D007684:Kidney Tubules / Q000473:pathology; D008833:Microcirculation / Q000473:pathology; D012077:Renal Artery / Q000473:pathology; D012079:Renal Circulation; D012082:Renal Veins / Q000473:pathology; D013552:Swine