Erythrocyte and Albumin Distribution in the Kidney Following Warm Ischemia

Abstract

A dark zone of probably stagnant erythrocytes, localised primarily to the inner stripe of the outer medulla, is always found in acute renal failure caused by clamping of the renal artery for 45 min. To test the possible accumulation of red cells, the regional renal red cell content was investigated with 51Cr labelled red cells injected before, during and 10 min after the recirculation. Analyses were made of the volumes of (1) cells remaining from the period of clamping, (2) cells aggregated 0--10 min after recirculation and (3) cells still circulating 10--20 min after recirculation. In the inner stripe the total red cell volume was 21.8 +/- 2.2 microliter . 100 mg-1 (control value 9.3 +/- 0.6), where 26% remained from the period of clamping, 46% had accumulated 0--10 min after recirculation, and only 28% had entered the region 10--20 min after recirculation. The same pattern of response, though less pronounced, was also found in the inner zone. In the cortex the total red cell volume was 6.3 +/- 1.2 microliter . 100 mg-1 (control value 4.4 +/- 0.3), where 24% remained from the period of clamping, 32% were accumulated and 44% remained circulating. The plasma volume as investigated from 131I-labelled albumin was markedly increased in all zones, probably due to extravasation of the tracer. It is suggested that red cell accumulation plays an important role for the medullary ischemia found in ischemic acute renal failure.

Post-Ischaemic Administration of Hyperosmolar Mannitol Enhances Erythrocyte Trapping in Outer Medullary Vasculature in the Rat Kidney

“…Previous studies have indicated that the RBC trapping occurs either during ischaemia [5,10] or in the very early recirculation phase [9,14], and disappears within less than 24 h [10,14]. It is evident from the results for the contra lateral intact kidneys in the present study that mannitol per se does not induce RBC trap ping.…”

“…The cell-labelling procedure has been described previously [9], Briefly, blood was collected in an acid-citrate-dextrose solution and cen trifuged. The plasma and 'huffy coat' were removed.…”

Is Allopurinol Beneficial in the Prevention of Renal Ischaemia—Reperfusion Injury in the Rat?: Evaluation by Near-Infrared Spectroscopy

“…In ischaemic kidneys, red blood cells become trapped within the microvasculature of the outer medulla [26][27][28][29][30][31][32]. Reperfusion is clearly dependent upon the number of red blood cells trapped and their speed of clearance.…”

Reduction of Renal Edema by Heparin in Postischemic Renal Damage

“…This phenomenon can be explained by a leakage of plasma fluid and proteins in the glomeruli and peritubular capillaries. The leakage of proteins might be of importance in the development of casts with subsequent tubular obstruction both in pa tients with ARF and in experimental RAO [Racusen et al, 1982], This exudation of plasma may also be responsible for the raised hematocrit value and red cell stagnation in the vasa recta and thus for the diminished perfusion in the outer medulla after RAO [Karlberg et al, 1982], Such changes at an early stage of the renal damage could be of importance for the development of the persistent impair ment of renal function. In other organs substances libe rated during the coagulation process have been shown to possess permeability-increasing properties.…”