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Review
. 2015 Jan;35(1):96-107.
doi: 10.1016/j.semnephrol.2015.01.010.

Renal endothelial injury and microvascular dysfunction in acute kidney injury

Sudhanshu Kumar Verma  1 , Bruce A Molitoris  2
Affiliations
Review

Renal endothelial injury and microvascular dysfunction in acute kidney injury

Sudhanshu Kumar Verma et al. Semin Nephrol. 2015 Jan.

Abstract

The kidney is comprised of heterogeneous cell populations that function together to perform a number of tightly controlled, complex and interdependent processes. Renal endothelial cells contribute to vascular tone, regulation of blood flow to local tissue beds, modulation of coagulation and inflammation, and vascular permeability. Both ischemia and sepsis have profound effects on the renal endothelium, resulting in microvascular dysregulation resulting in continued ischemia and further injury. In recent years, the concept of the vascular endothelium as an organ that is both the source of and target for inflammatory injury has become widely appreciated. Here we revisit the renal endothelium in the light of ever evolving molecular advances.

Keywords: AKI; Kidney; endothelium.

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Figures

Figure 1
Figure 1
Schematic representation of the visional difference in the microvasculature within the kidney. OSOM, outer stripe of the outer medulla; ISOM, inner stripe of the outer medulla; IM, inner medulla; PCT, proximal convoluted tubule; PST, proximal straight tubule; DLT, descending thin limb; DCT, distal convoluted tubule; CCD, cortical collecting duct; OMCD, outer medullary collecting duct; IMCD, inner medullary collecting duct; AA, arctuate artery; IA, interlobular artery. (Reprinted with permission from Endothelial Biomedicine, Ed. William C. Aird, 2007, Cambridge University Press, Chapter 138, Pg. 1271).
Figure 2
Figure 2
Schematic representation of the different forms of ECs found within the peritubular microvasculature of the kidney in the different zones of the kidney. (Reprinted with permission from Pallone TL, Turner MR, Edwards A, Jamison RL. Countercurrent exchange in the renal medulla. Am J Physiol Regul Inter Comp Physiol. 2003;284:R1153-R1175)
Figure 3
Figure 3
Kidney depicted as multiple vascular compartments connected in series with parallel components in each compartment. The total vascular resistance is equal to the sum of vascular resistances within the different compartments. Also shown, the associated disease conditions/syndromes within each compartment.
See this image and copyright information in PMC

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