Recovery from renal ischemia-reperfusion injury is associated with altered renal hemodynamics, blunted pressure natriuresis, and sodium-sensitive hypertension

Am J Physiol Regul Integr Comp Physiol. 2009 Nov;297(5):R1358-63. doi: 10.1152/ajpregu.91022.2008. Epub 2009 Aug 26.

Abstract

The present studies evaluated intrarenal hemodynamics, pressure natriuresis, and arterial blood pressure in rats following recovery from renal ischemia-reperfusion (I/R) injury. Acute I/R injury, induced by 40 min of bilateral renal arterial occlusion, resulted in an increase in plasma creatinine that resolved within a week. Following 5 wk of recovery on a 0.4% NaCl diet, the pressure-natriuresis response was assessed in anesthetized rats in which the kidney was denervated and extrarenal hormones were administered intravenously. Increasing renal perfusion pressure (RPP) from 107 to 141 mmHg resulted in a fourfold increase in urine flow and sodium excretion in sham control rats. In comparison, pressure diuresis and natriuresis were significantly attenuated in post-I/R rats. In sham rats, glomerular filtration rate (GFR) averaged 1.6 +/- 0.2 mlxmin(-1)xg kidney weight(-1) and renal blood flow (RBF) averaged 7.8 +/- 0.7 mlxmin(-1)xg kidney weight(-1) at RPP of 129 mmHg. Renal cortical blood flow, measured by laser-Doppler flowmetry, was well autoregulated whereas medullary blood flow and renal interstitial hydrostatic pressure increased directly with elevated RPP in sham rats. In contrast, GFR and RBF were significantly reduced whereas medullary perfusion and interstitial pressure demonstrated an attenuated response to RPP in post-I/R rats. Further experiments demonstrated that conscious I/R rats develop hypertension when sodium intake is increased. The present data indicate that the pressure-natriuretic-diuretic response in I/R rats is blunted because of a decrease in GFR and RBF and the depressed pressure-dependent increase in medullary blood flow and interstitial pressure.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Animals
  • Blood Pressure / drug effects
  • Blood Pressure / physiology
  • Creatinine / blood
  • Disease Models, Animal
  • Glomerular Filtration Rate / drug effects
  • Glomerular Filtration Rate / physiology
  • Hypertension, Renal / chemically induced
  • Hypertension, Renal / physiopathology*
  • Kidney / blood supply
  • Kidney / physiopathology*
  • Kidney Cortex / blood supply
  • Kidney Cortex / physiopathology
  • Kidney Diseases / physiopathology*
  • Kidney Medulla / blood supply
  • Kidney Medulla / physiopathology
  • Male
  • Natriuresis / physiology*
  • Rats
  • Rats, Sprague-Dawley
  • Recovery of Function / physiology*
  • Regional Blood Flow / drug effects
  • Regional Blood Flow / physiology
  • Reperfusion Injury / physiopathology*
  • Sodium / urine
  • Sodium Chloride, Dietary / adverse effects*
  • Sodium Chloride, Dietary / pharmacology

Substances

  • Sodium Chloride, Dietary
  • Sodium
  • Creatinine