Controversies on glomerular filtration from Ludwig to the present

Abstract

Since Ludwig's theory of filtration in the glomerulus is generally accepted, current research interest has focussed on the regulation of this process. The main determinants of glomerular filtration rate are glomerular capillary pressure and glomerular blood flow, which are adjusted via resistance changes in the pre- and postglomerular vasculature. Overall pre- and postglomerular resistances were first determined by micropuncture in superficial glomeruli. While the predominant source of postglomerular resistance is the efferent arteriole, several results indicate that preglomerular resistance might be rather uniformly distributed among all preglomerular vessels (interlobar, arcuate and interlobular arteries and afferent arterioles). Over the last decade, several techniques have been used to visualize renal vessels and to study the action of various vasoactive hormones thereon. Results obtained with the split hydronephrotic kidney model, which permits in vivo microscopy of all renal vessels, provide evidence for a differential regulation of the various preglomerular vessels by vasoactive hormones. In particular, mediators of inflammation almost selectively constrict interlobar and arcuate arteries. We conclude that, given the renal vascular architecture, differential regulation of preglomerular vessels can alter haemodynamic parameters specifically for different nephron populations.