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Division of Nephrology, University of Maryland School of Medicine, Baltimore, Maryland 21201-1595
Perfusion of the renal medulla plays an
important role in salt and water balance. Pericytes are smooth
muscle-like cells that impart contractile function to descending vasa
recta (DVR), the arteriolar segments that supply the medulla with blood
flow. DVR contraction by ANG II is mediated by depolarization resulting from an increase in plasma membrane Cl
conductance that
secondarily gates voltage-activated Ca2+ entry. In this
respect, DVR may differ from other parts of the efferent
microcirculation of the kidney. Elevation of extracellular K+ constricts DVR to a lesser degree than ANG II or
endothelin-1, implying that other events, in addition to membrane
depolarization, are needed to maximize vasoconstriction. DVR
endothelial cytoplasmic Ca2+ is increased by bradykinin, a
response that is inhibited by ANG II. ANG II inhibition of endothelial
Ca2+ signaling might serve to regulate the site of origin
of vasodilatory paracrine agents generated in the vicinity of outer
medullary vascular bundles. In the hydropenic kidney, DVR plasma
equilibrates with the interstitium both by diffusion and through water
efflux across aquaporin-1. That process is predicted to optimize
urinary concentration by lowering blood flow to the inner medulla. To optimize urea trapping, DVR endothelia express the UT-B facilitated urea transporter. These and other features show that vasa recta have
physiological mechanisms specific to their role in the renal medulla.
vasa recta; perfusion; hypertension; oxygenation; urinary concentration; patch clamp; calcium; fura 2
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