부산대학교 도서관

The pathogenesis of medullary vascular congestion?red blood cell (RBC) aggregation in the renal medulla vasculature?after renal ischemia has been uncertain. In a rat model, the authors found that during ischemia, sludging of RBCs occurs in the renal venous vasculature. Because recovery of cortical perfusion is required to displace this stalled blood in the shared venous vessels?which drain both the cortex and medulla?restoration of blood flow to the medulla before restoration to the cortex results in tightly packed RBC congestion of the medullary circulation. This congestion then prevents later reperfusion of the medulla, even after blood flow is restored to the cortex, resulting in tubular injury. These findings support a hemodynamic explanation for the susceptibility of the renal medulla to ischemic injury.