Effect of hemorrhage and retransfusion on intrarenal distribution of blood flow in dogs

Abstract

Distribution of intrarenal blood flow was studied in 12 dogs anesthetized with Nembutal. Medullary blood flow was estimated by local clearance of hydrogen gas from the outer medulla measured polarographically with needleshaped platinum electrodes, and by local clearance of (85)Kr and mean transit time of (32)P-labeled erythrocytes measured with a small semiconductor detector placed in the outer medulla. Cortical blood flow was estimated from cortical red cell transit time and from total renal blood flow measured by electromagnetic flowmeter. Bleeding to a mean arterial pressure of 50-65 mm Hg in the course of 8-20 min reduced cortical and medullary blood flow on the average to the same extent. In half of the experiments both cortical and medullary blood flow were reduced proportionately less than mean arterial pressure during the first half hour of bleeding. Maintenance of mean arterial pressure at 50-65 mm Hg in all cases led to progressive reduction of both cortical and medullary blood flow, out of proportion to the reduction of arterial pressure. A two step bleeding procedure used in two experiments also led to uniform reduction of renal blood flow. Reinfusion of blood after 2-3 hr of hypotension increased total renal blood flow to an average of 82% and outer medullary hydrogen clearance to an average of 92% of control values. All dogs survived the experiment without evidence of renal failure. It is concluded that hemorrhagic hypotension in dogs leads to a progressive and fairly uniform rise in renal vascular resistance, without any selective hemodynamic response in the juxtamedullary circulation.