[The regulatory mechanisms of glomerular filtration: the tubuloglomerular feedback system, physiological aspects and their participation in the physiopathology of kidney diseases].

The tubuloglomerular feedback system (TGF), the main component of the autoregulation mechanism, maintains constant glomerular blood flow and filtration rate. The system is based in the morpho-functional association among the macula densa, the afferent and efferent arterioles, the glomerulus and the extraglomerular mesangial cells. The macula densa cells sense the changes in solute concentrations and osmolarity in the tubular fluid and send vasoconstrictor or vasodilatory signals to the arterioles that modify blood flow and glomerular filtration rate. However, the mechanism by which the macula densa sends signals to the arterioles remains unknown. A chemical mediator such as prostaglandins or adenosine has been postulated. Our studies discarded the participation of prostaglandins as mediators. Further studies from our group with adenosine analogs indicate that this nucleotide participates in the activation of the TGF responses, and suggest alternate activation pathways not previously described. To evaluate the role of TGF feedback in the glomerular hemodynamic changes associated with progression of renal damage, we studied TGF responses in rats with Goldblatt hypertension and partial ablation of the contralateral kidney. Our results suggest that the sensitivity of the system is decreased. This alteration may contribute to glomerular hypertension and progression to renal damage.