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Medullary plasma flow and intravascular leukocyte accumulation in acute renal failure

1974; Elsevier BV; Volume: 6; Issue: 1 Linguagem: Inglês

10.1038/ki.1974.74

1523-1755

Kim Solez, Elizabeth C. Kramer, Jennifer Fox, R. H. Heptinstall,

Acute Kidney Injury Research

Medullary plasma flow and intravascular leukocyte accumulation in acute renal failure. The accumulation of nucleated cells in the vasa recta in acute renal failure has been attributed to intravascular hematopoiesis caused by reduced medullary blood flow. Medullary plasma flow was determined in rats with HgCl 2 -induced acute renal failure by infusing 125 I-albumin i.v. for 15 or 30sec and measuring radioactivity in plasma and the renal papillae. Measurements made 40 to 48hr after i.v. injection of HgCl 2 revealed a significantly raised medullary plasma flow at a time when there were prominent collections of nucleated cells in the vasa recta. Vascular tracer studies using India ink demonstrated that blood flow was maintained in vasa recta which contained nucleated cells. Electron microscopic and histochemical studies showed that these cells were lymphocytes, neutrophils and monocytes, present in approximately the same proportions as in the peripheral blood. It is suggested that the nucleated cells in the vasa recta are not produced within the kidney, but are brought there via the circulating blood. Their accumulation within the vasa recta is unexplained but is unrelated to a reduction in medullary blood flow. Debit medullaire et accumulation intravasculaire de leucocytes dans l'insuffisance renale aigue. L'accumulation de cellules nucleees dans les vasa recta au cours de l'insuffisance renal aigue a ete attribuee a l'hematopoiese intravasculaire determinee par le diminution du debit sanguin medullaire. Le debit medullaire a ete determine chez des rats atteints d'insuffisance renale aigue induite par HgCl 2 au moyen d'une perfusion intraveineuse d'albumine 125 I durant 15 ou 30 seconds et de la mesure de la radioactivite du plasma et de la papille renale. Les determinations faites 40 a 48 heures apres l'injection intraveineuse de HgCl 2 montrent une augmentation significative du debit medullaire contemporaine de l'existence de quantites importantes de cellules nucleees dans les vasa recta. Les etudes vasculaires a l'aide de l'encre de chine comme traceur demontrent que le debit sanguin est maintenu dans les vasa recta qui contiennent des cellules nucleees. La microscopie electronique et les etudes histochimiques montrent que ces cellules sont des lymphocytes, des neutrophiles et des monocytes, approximativement dans les memes proportions que dans le sang peripherique. II est suggere que les cellules nucleees des vasa recta ne sont pas produites dans le rein mais y sont apportees par la circulation sanguine. Leur accumulation a l'interieur des vasa recta n'est pas expliquee mais elle n'est pas la consequence d'une diminution du debit sanguin medullaire.