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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. kidney renal hemodynamics renal medullary blood flow hypertension Footnotes Address for reprint requests and other correspondence: D. L. Mattson, Dept. of Physiology, Medical College of Wisconsin, 8701 Watertown Plank Rd., PO Box 26509, Milwaukee, WI 53226-0509 (E-mail: dmattson@mcw.edu ). 10.1152/ajpregu.00321.2002 Copyright © 2003 the American Physiological Society
AJP - Regulatory, Integrative and Comparative Physiology – The American Physiological Society
Published: Jan 1, 2003
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