| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
INVITED REVIEW
1Smooth Muscle Research Group, University of Calgary, Alberta, Canada; 2Department of Internal Medicine, Loyola University Medical Center and Edward Hines, Jr. Veterans Affairs Hospital, Maywood, Illinois; and 3Department of Electrical and Computer Engineering, Illinois Institute of Technology, Chicago, Illinois
When the kidney is subjected to acute increases in blood pressure (BP), renal blood flow (RBF) and glomerular filtration rate (GFR) are observed to remain relatively constant. Two mechanisms, tubuloglomerular feedback (TGF) and the myogenic response, are thought to act in concert to achieve a precise moment-by-moment regulation of GFR and distal salt delivery. The current view is that this mechanism insulates renal excretory function from fluctuations in BP. Indeed, the concept that renal autoregulation is necessary for normal renal function and volume homeostasis has long been a cornerstone of renal physiology. This article presents a very different view, at least regarding the myogenic component of this response. We suggest that its primary purpose is to protect the kidney against the damaging effects of hypertension. The arguments advanced take into consideration the unique properties of the afferent arteriolar myogenic response that allow it to protect against the oscillating systolic pressure and the accruing evidence that when this response is impaired, the primary consequence is not a disturbed volume homeostasis but rather an increased susceptibility to hypertensive injury. It is suggested that redundant and compensatory mechanisms achieve volume regulation, despite considerable fluctuations in distal delivery, and the assumed moment-by-moment regulation of renal hemodynamics is questioned. Evidence is presented suggesting that additional mechanisms exist to maintain ambient levels of RBF and GFR within normal range, despite chronic alterations in BP and severely impaired acute responses to pressure. Finally, the implications of this new perspective on the divergent roles of the myogenic response to pressure vs. the TGF response to changes in distal delivery are considered, and it is proposed that in addition to TGF-induced vasoconstriction, vasodepressor responses to reduced distal delivery may play a critical role in modulating afferent arteriolar reactivity to integrate the regulatory and protective functions of the renal microvasculature.
renal microcirculation; afferent arteriole; myogenic; tubuloglomerular feedback
This article has been cited by other articles:
|
|
 |
|
  K. J. Schjoedt, P. K. Christensen, A. Jorsal, F. Boomsma, P. Rossing, and H.-H. Parving Autoregulation of glomerular filtration rate during spironolactone treatment in hypertensive patients with type 1 diabetes: a randomized crossover trial Nephrol. Dial. Transplant., November 1, 2009; 24(11): 3343 - 3349. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Z. Guan, J. S. Pollock, A. K. Cook, J. L. Hobbs, and E. W. Inscho Effect of Epithelial Sodium Channel Blockade on the Myogenic Response of Rat Juxtamedullary Afferent Arterioles Hypertension, November 1, 2009; 54(5): 1062 - 1069. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Ponnuchamy and R. A. Khalil Cellular mediators of renal vascular dysfunction in hypertension Am J Physiol Regulatory Integrative Comp Physiol, April 1, 2009; 296(4): R1001 - R1018. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. W. Inscho, A. K. Cook, R. C. Webb, and L.-M. Jin Rho-kinase inhibition reduces pressure-mediated autoregulatory adjustments in afferent arteriolar diameter Am J Physiol Renal Physiol, March 1, 2009; 296(3): F590 - F597. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Khavandi, A. S. Greenstein, K. Sonoyama, S. Withers, A. Price, R. A. Malik, and A. M. Heagerty Myogenic tone and small artery remodelling: insight into diabetic nephropathy Nephrol. Dial. Transplant., February 1, 2009; 24(2): 361 - 369. [Full Text] [PDF]
|
|
|
|
|
|
E. W. Inscho Mysteries of Renal Autoregulation Hypertension, February 1, 2009; 53(2): 299 - 306. [Full Text] [PDF]
|
|
|
|
 |
|
 K. A. Earle, D. Harry, M. Madhavi, K. Zitouni, and J. Barron Nitric Oxide Bioavailability and Its Potential Relevance to the Variation in Susceptibility to the Renal and Vascular Complications in Patients With Type 2 Diabetes Diabetes Care, January 1, 2009; 32(1): 138 - 140. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. F. Mitchell Effects of central arterial aging on the structure and function of the peripheral vasculature: implications for end-organ damage J Appl Physiol, November 1, 2008; 105(5): 1652 - 1660. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. A. Williamson, R. Loutzenhiser, X. Wang, K. Griffin, and A. K. Bidani Systolic and mean blood pressures and afferent arteriolar myogenic response dynamics: a modeling approach Am J Physiol Regulatory Integrative Comp Physiol, November 1, 2008; 295(5): R1502 - R1511. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Iliescu, R. Cazan, G. R. McLemore Jr., M. Venegas-Pont, and M. J. Ryan Renal blood flow and dynamic autoregulation in conscious mice Am J Physiol Renal Physiol, September 1, 2008; 295(3): F734 - F740. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. W. Brands and H. Labazi Role of Glomerular Filtration Rate in Controlling Blood Pressure Early in Diabetes Hypertension, August 1, 2008; 52(2): 188 - 194. [Full Text] [PDF]
|
|
|
|
|
|
X. Wang, K. Takeya, P. I. Aaronson, K. Loutzenhiser, and R. Loutzenhiser Effects of amiloride, benzamil, and alterations in extracellular Na+ on the rat afferent arteriole and its myogenic response Am J Physiol Renal Physiol, July 1, 2008; 295(1): F272 - F282. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. P. Koeners, B. Braam, D. M. van der Giezen, R. Goldschmeding, and J. A. Joles A perinatal nitric oxide donor increases renal vascular resistance and ameliorates hypertension and glomerular injury in adult fawn-hooded hypertensive rats Am J Physiol Regulatory Integrative Comp Physiol, June 1, 2008; 294(6): R1847 - R1855. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. A. Griffin, H. Kramer, and A. K. Bidani Adverse renal consequences of obesity Am J Physiol Renal Physiol, April 1, 2008; 294(4): F685 - F696. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. A. Drummond, S. C. Grifoni, and N. L. Jernigan A New Trick for an Old Dogma: ENaC Proteins as Mechanotransducers in Vascular Smooth Muscle Physiology, February 1, 2008; 23(1): 23 - 31. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. Telezhkin, T. Goecks, A. D. Bonev, G. Osol, and N. I. Gokina Decreased function of voltage-gated potassium channels contributes to augmented myogenic tone of uterine arteries in late pregnancy Am J Physiol Heart Circ Physiol, January 1, 2008; 294(1): H272 - H284. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. A. Griffin, M. Abu-Naser, I. Abu-Amarah, M. Picken, G. A. Williamson, and A. K. Bidani Dynamic blood pressure load and nephropathy in the ZSF1 (fa/facp) model of type 2 diabetes Am J Physiol Renal Physiol, November 1, 2007; 293(5): F1605 - F1613. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Wan, R. Bellomo, and C. N. May The Effects of Normal and Hypertonic Saline on Regional Blood Flow and Oxygen Delivery Anesth. Analg., July 1, 2007; 105(1): 141 - 147. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. A. Cupples and B. Braam Assessment of renal autoregulation Am J Physiol Renal Physiol, April 1, 2007; 292(4): F1105 - F1123. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Eskild-Jensen, K. Thomsen, C. Rungo, L. S. Ferreira, L. F. Paulsen, Y. F. Rawashdeh, J. R. Nyengaard, S. Nielsen, J. C. Djurhuus, and J. Frokiaer Glomerular and tubular function during AT1 receptor blockade in pigs with neonatal induced partial ureteropelvic obstruction Am J Physiol Renal Physiol, March 1, 2007; 292(3): F921 - F929. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Just Mechanisms of renal blood flow autoregulation: dynamics and contributions Am J Physiol Regulatory Integrative Comp Physiol, January 1, 2007; 292(1): R1 - R17. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. A. Griffin and A. K. Bidani Progression of Renal Disease: Renoprotective Specificity of Renin-Angiotensin System Blockade Clin. J. Am. Soc. Nephrol., September 1, 2006; 1(5): 1054 - 1065. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. B. Persson Where we stand: American Journal of Physiology--Regulatory, Integrative and Comparative Physiology 2006 Am J Physiol Regulatory Integrative Comp Physiol, September 1, 2006; 291(3): R489 - R490. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Visit Other APS Journals Online |
