The two kidneys of mammalian organisms receive around 25 % of the
cardiac output at rest, of which only 7 % is distributed to the
renal medulla. Despite the low blood flow to the renal medulla,
small changes in perfusion to the region can have profound effects
on urine-concentrating ability and the excretion of sodium, which
in turn affects the chronic regulation of body fluid volumes and
arterial blood pressure. Importantly, we know that if blood flow to
the renal medulla is not tightly regulated, sodium and water
homeostasis is impaired and medullary hypoxia develops. The
resultant injury inevitably reduces urine concentrating ability and
leads to hypertension. This book will discuss the variety of
mechanisms that mammalian organisms have developed to ensure that
renal medullary blood flow and oxygen levels are precisely
regulated. This book will focus on the unique anatomical
arrangement of the medullary circulation, the functional roles of
medullary blood flow, as well as the experimental techniques used
to assess medullary blood flow and the insight that these studies
have provided. The hormonal and non-hormonal control of medullary
blood flow will be considered and finally the impact of reduced
medullary blood flow on blood pressure is discussed.
General
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