Källskog O, Hellström I, Rissler K, Wolgast M
Ren Physiol. 1985;8(6):328-37. doi: 10.1159/000173065.
A study was made on the number of glomeruli in the outer cortex, midcortex, and inner cortex 4 weeks after 45 min of warm ischemia, using alcian blue to stain functioning glomeruli. During this time the stainable glomeruli in the kidney as a whole had decreased in number from 32,000 to 16,800. The superficial glomeruli were reduced by only about 30%, whereas in the juxtamedullary zones the number of functioning nephrons were reduced by 80%. This shows that the juxtamedullary nephrons are the most susceptible to degeneration in the recovery phase of acute renal failure caused by ischemia. The decrease in the number of glomeruli was accompanied by a reduction in total glomerular filtration rate to about the same extent. In contrast, the kidney weight was reduced by only about 20%, suggesting compensatory hypertrophy of the remaining tubules. Fluid reabsorption, urine osmolality, and potassium-secreting ability also remained decreased. The contralateral kidney responded with a compensatory hypertrophy and an increase in glomerular filtration rate, whereas the number of glomeruli in the cortex as a whole and in the individual cortical zones in this kidney remained the same as in control kidneys. It is suggested that the trapping of red cells in the juxtamedullary circulation seen soon after restoration of circulation to kidneys subjected to warm ischemia will also cause a further degeneration of the juxtamedullary nephrons.
对45分钟热缺血4周后的肾外皮质、中皮质和内皮质中的肾小球数量进行了研究，使用阿尔辛蓝对功能正常的肾小球进行染色。在此期间，整个肾脏中可染色的肾小球数量从32,000个减少到16,800个。浅表肾小球仅减少了约30%，而在近髓质区域，功能正常的肾单位数量减少了80%。这表明在缺血引起的急性肾衰竭恢复期，近髓质肾单位最易发生退变。肾小球数量的减少伴随着肾小球滤过率总体上约相同程度的降低。相比之下，肾脏重量仅减少了约20%，提示剩余肾小管出现代偿性肥大。液体重吸收、尿渗透压和钾分泌能力也仍然降低。对侧肾脏出现代偿性肥大，肾小球滤过率增加，而该肾脏的整个皮质以及各个皮质区域中的肾小球数量与对照肾脏相同。有人提出，在对遭受热缺血的肾脏恢复血液循环后不久，在近髓质循环中出现的红细胞滞留也会导致近髓质肾单位进一步退变。
