Measurement of intrarenal blood flow. I. Analysis of microsphere method

An autoradiographic study of regional blood flow distribution in the rat kidney during ureteric obstruction--the role of vasoactive compounds

OBJECTIVE

To determine the changes in regional renal blood flow during ureteric obstruction and to examine the role of vasoactive mediators in effecting these changes.

MATERIALS AND METHODS

Renal blood flow in Sprague-Dawley rats was assessed after periods of ureteric obstruction using a quantitative autoradiographic technique based on Kety's theory of diffusion of an inert tracer (14C-iodoantipyrine). Prostaglandins, thromboxanes and renin-angiotensin were inhibited pharmacologically using diclofenac sodium and enalapril.

RESULTS

Baseline blood flow to the outer cortex, inner cortex and medulla was 807, 258 and 105 mL/100 g/min, respectively. There was an increase in outer cortical blood flow after 10 min of ureteric obstruction which became significant at 30 min (P < 0.05). There was a significant decrease in inner cortical and medullary blood flow at 30 min, to 210 and 68 mL/100 g/min, respectively (P < 0.05). Diclofenac sodium abolished the increase in outer cortical blood flow. After 24 h of unilateral ureteric obstruction, outer cortical blood flow decreased to 492 mL/100 g/min; inner cortical blood flow also decreased but to a lesser extent, to 190 mL/100 g/min. Inhibition of prostaglandins, thromboxanes and the renin-angiotensin system reduced the degree of renal vasoconstriction but there was still a significant decrease in outer cortical perfusion despite the presence of these blocking agents.

CONCLUSIONS

The control of the renal vasculature involves a complex interplay between a variety of vasoactive mediators. Quantitative autoradiography offers the opportunity to evaluate changes in regional renal perfusion with high resolution and will allow a greater understanding of the pathophysiology of renal diseases.

Renal blood flow measurement by positron emission tomography using 15O-labeled water

BACKGROUND

Only few noninvasive methods have the potential to quantitate renal blood flow (RBF) in humans. Positron emission tomography (PET) is a clinical imaging method that can be used to measure the tissue blood flow noninvasively. The purpose of this study was to validate PET measurement of RBF using 15O-labeled water (H215O), a tracer that allows repeated measurements at short time intervals.

METHODS

RBF was measured in six pigs by PET and by radioactive microspheres (MS). Three measurements were performed in each pig at baseline (BL), during vascular expansion and dopamine infusion (DA; 20 microg. kg-1. min-1 intravenously), and during angiotensin II (Ang II) infusion (50 ng. kg-1. min-1 intravenously). RBF was estimated from aortic and renal tracer kinetics using a model adapted from the blood flow model described by Kety and Smith.

RESULTS

PET and MS values correlated strongly (y = 0.79x + 42, r = 0.93, P < 0.0001) over the RBF range from 100 to 500 mL. min-1. 100 g-1. Pharmacologically induced changes were significant and were measured equally well by PET and MS: 38 and 39%, respectively, below BL (P < 0.005 and P < 0.05) under Ang II, and 47 and 48%, respectively, above BL (P < 0.005 and P < 0.01) under DA. A Bland and Altman representation showed a low average difference of -17 +/- 45 mL. min-1. 100 g-1 (mean +/- SD).

CONCLUSION

To our knowledge, this study provides the first validation of RBF measurement by PET using H215O over a large range of RBF values (100 to 500 mL. min-1. 100 g-1), which correspond to RBF values in both healthy subjects and in patients suffering from chronic renal failure.

The development of x-ray imaging to study renal function

The well-established role of the kidney in control of blood volume and ultimately arterial blood pressure has been underscored by the demonstration of alterations in renal hemodynamics and function recognized as responsible for these and other regulatory mechanisms. Nevertheless, the spatial complexity of intrarenal structure and function has made evident the need to study these separately in different regions of the intact kidney. Because of the introduction of x-rays, assessment of renal function has indeed been one of their attractive applications. However, despite the appeal of their noninvasiveness, several limitations confounded the different x-ray techniques used, most of which remained unresolved until the development of computed tomography. Furthermore, the development of fast imaging, which allows repetitive analysis of the same region of interest during the transit of contrast medium, holds a great potential to estimate intrarenal distribution of blood flow and the dynamic characteristics of tubular fluid flow in individual nephron segments. This latter assessment requires the administration of filterable x-ray contrast medium, which is cleared from the plasma almost exclusively by glomerular filtration, and the generation of contrast dilution curves. A historical review of the development and progress of the various x-ray techniques used will help understand the past and present of x-ray imaging, and will make it easier to envision the importance of their future roles in the study of renal physiology and pathophysiology.

Assessment of Renal Perfusion in a Canine Model Using FS069, A New Transpulmonary Echocontrast Agent

We have previously demonstrated the safety and efficacy of FS069, a new transpulmonary echocontrast agent, for myocardial opacification. To our knowledge, no information exists regarding the use of this agent for transcutaneous assessment of renal perfusion. We studied 14 mongrel dogs using intravenously administered FS069. Renal ultrasound imaging was performed with a Hewlett-Packard Sonos 1500 using a 3.5-MHz transducer. Renal blood flow (ReBF) was altered using renal artery occlusion in four dogs and dipyridamole (0.56 mg/kg IV) in ten dogs. Renal perfusion was quantitatively assessed before and after each intervention using background subtracted peak intensity. ReBF was assessed with radiolabeled microspheres in ten dogs. Renal opacification was observed in all 14 dogs at baseline. The intravenous contrast dose required to produce optimal renal opacification ranged from 0.3-0.7 cc. After renal artery occlusion, peak intensity was reduced from 5.4 +/- 5.8 to 0.93 +/- 1.1 units (r = 0.99, P < 0.008). As expected, blood pressure and ReBF dropped in all ten dogs after dipyridamole administration. Interestingly, peak intensity increased in all but one dog. An inverse correlation (r = -0.75, P = 0.02) was observed between ReBF and peak intensity (percent change from baseline). The inverse relation between ReBF and peak intensity observed suggests vasoconstriction of the afferent arterioles in response to dipyridamole and a reduced clearance of the contrast. These findings are in agreement with previous data demonstrating decreased renal thallium clearance postdipyridamole administration. Our data document the feasibility to assess renal perfusion under various flow states after intravenous injection of FS069.

Impact of systemic depulsation on tissue perfusion and sympathetic nerve activity

BACKGROUND

We postulated that pathophysiologic processes under nonpulsatile circulation are related to the behavior of the sympathetic nerve activity that regulates tissue perfusion.

METHODS

Pulsatile and nonpulsatile pumps were installed in parallel in the left heart bypass circuit of anesthetized goats (n = 9) so that pulsatile circulation could be converted to nonpulsatile circulation instantly. At 5 minutes before and after systemic depulsation, we measured hemodynamic indices, renal nerve activity, and regional blood flow of the brain, heart, and renal cortex.

RESULTS

Renal nerve activity was significantly elevated after systemic depulsation (15.6 +/- 9.3 versus 19.4 +/- 9.8 microV), when mean aortic pressure remained almost constant. The renal cortical flow was significantly reduced after depulsation (3.61 +/- 1.23 versus 2.93 +/- 1.19 mL.min-1.g-1), whereas no significant difference was found in the regional blood flow of the brain or the heart.

CONCLUSIONS

The significant reduction of renal cortical blood flow after systemic depulsation is associated with a significant increase in renal nerve activity. Our results suggest that increased renal nerve activity plays an important role in the reduction of renal function after systemic depulsation.

Methods of renal blood flow measurement

Variations in regional renal blood flow have been implicated in a variety of disease states. Many techniques have been developed in an attempt to accurately assess these changes. The microsphere technique is the most widely used method at the present time. This technique allows focal measurements to be performed, but there is a conflict between the resolution of the method and the number of microspheres necessary in each sample. New imaging techniques such as tomography and autoradiography enable visual assessment of renal blood flow. Though there is no ideal method, these techniques have opened up new possibilities in the quantification of regional renal blood flow.

Reproducibility of human kidney perfusion and volume determinations with electron beam computed tomography

RATIONALE AND OBJECTIVES

Alterations in whole kidney, cortical, and medullary perfusion and volume play a pivotal role in various physiologic and pathophysiologic processes. Electron-beam computed tomography (EBCT) provides accurate measurements of these traits in animals, but their reproducibility in humans has not been established.

METHODS

Perfusion, volume, and flow measurements were obtained by EBCT in eight healthy human volunteers under controlled conditions on two consecutive days.

RESULTS

Mean values for whole kidney, cortical, and medullary perfusion and volume obtained with EBCT were similar in scan 1 and scan 2 (P > 0.1), and correlated highly. Coefficients of variation for the repeated measurements usually were less than 10%. Values obtained for renal regional perfusion and volume agreed with previously reported values.

CONCLUSIONS

Electron-beam computed tomography estimates of single whole kidney, cortical, and medullary perfusions and volumes are highly reproducible in normal humans, and may be useful to advance understanding of renal involvement in human disease.

Increasing organ blood flow during cardiopulmonary bypass in pigs: comparison of dopamine and perfusion pressure

OBJECTIVE

To determine whether low-dose dopamine infusion (5 micrograms/kg/min) during cardiopulmonary bypass selectively increases perfusion to the kidney, splanchnic organs, and brain at low (45 mm Hg) as well as high (90 mm Hg) perfusion pressures.

DESIGN

Randomized crossover trial.

SETTING

Animal research laboratory in a university medical center.

SUBJECTS

Ten female Yorkshire pigs (weight 29.9 +/- 1.2 kg).

INTERVENTION

Anesthetized pigs were placed on normothermic cardiopulmonary bypass at a 100-mL/kg/min flow rate. After baseline measurements, the animal was subjected, in random sequence, to 15-min periods of low perfusion pressure (45 mm Hg), low perfusion pressure with dopamine (5 micrograms/kg/min), high perfusion pressure (90 mm Hg), and high perfusion pressure with dopamine. Regional perfusion (radioactive microspheres) was measured in tissue samples (2 to 10 g) from the renal cortex (outer two-third and inner one-third segments), stomach, duodenum, jejunum, ileum, colon, pancreas, and cerebral hemispheres.

MEASUREMENTS AND MAIN RESULTS

Systemic perfusion pressure was altered by adjusting pump flow rate (r2 = .61; p < .05). In the kidney, cortical perfusion pressure increased from 178 +/- 16 mL/min/100 g at the low perfusion pressure to 399 +/- 23 mL/min/100 g at the high perfusion pressure (p < .05). Perfusion pressure augmentation increased the ratio of outer/inner renal cortical blood flow from 0.9 +/- 0.1 to 1.2 +/- 0.1 (p < .05). At each perfusion pressure, low-dose dopamine had no beneficial effect on renal perfusion or flow distribution. Similar results were found in the splanchnic organs, where regional perfusion was altered by perfusion pressure but not by dopamine. In contrast, neither changing perfusion pressure nor adding low-dose dopamine altered blood flow to the cerebral cortex.

CONCLUSIONS

These data indicate that the lower autoregulatory limits of perfusion to the kidneys and splanchnic organs differ from those limits to the brain during normothermic bypass. Selective vasodilation from low-dose dopamine was not found in renal, splanchnic, or cerebral vascular beds. Increasing the perfusion pressure by pump flow, rather than by the addition of low-dose dopamine, enhanced renal and splanchnic but not cerebral blood flows during cardiopulmonary bypass.

Regional renal blood flow in normal and disease states

Renal function is intimately dependent on renal blood flow. Alterations in either total or regional renal blood flow have major consequences for renal function. Through homeostatic mechanisms the kidneys are able to maintain relatively stable rates of flow over a wide range of perfusion pressures. A combination of neural, endocrine, exocrine and autocrine signals serve to regulate renal blood flow at both local and systemic levels. Alterations in the balance of these systems occur in the presence of certain pathophysiological conditions and an understanding of the subsequent changes in regional renal blood flow distribution aids in the understanding of the associated changes in renal function. The regulation and distribution of regional blood flow and the effects of surgical and pathophysiological conditions on these factors are reviewed.

Effects of systemic hypoxia on the distribution of cardiac output in the rat

1. Studies were made in unanaesthetized rats of cardiovascular responses induced during 3 min periods of systemic hypoxia (inspirate 8 or 6% O2). Arterial pressure and heart rate were recorded continuously; cardiac index and regional blood flows were measured in normoxia and at the 2nd min of hypoxia by injection of radiolabelled microspheres. Comparisons are made with changes recorded in Saffan-anaesthetized rats during 8% O2 using microspheres and in previous studies using electromagnetic transducers on renal, mesenteric and femoral arteries (Marshall & Metcalfe, 1988a). 2. In unanaesthetized rats, the initial 1-1.5 min of hypoxia evoked behavioural arousal associated with a short-lasting rise in arterial pressure and heart rate. This agrees with our previous proposal that hypoxia activates the brain stem defence areas by stimulating peripheral chemoreceptors. 3. In unanaesthetized rats, these changes were superimposed upon a gradual fall in arterial pressure and tachycardia, the responses being greater during 6 than 8% O2 (cf. Saffan-anaesthetized rats). Further, in all rats at the 2nd min of hypoxia, cardiac index and vascular conductance of most body tissues was increased. It is concluded that the fall in arterial pressure is due to peripheral vasodilatation. 4. In the unanaesthetized rats, the tendency for vascular conductance in kidney, intestine and gastrocnemius muscle to increase (more during 6 than 8% O2) allowed increases in blood flow in the last two regions. These changes accord with those recorded under Saffan anaesthesia. 5. In both unanaesthetized and anaesthetized rats, hypoxia induced pronounced increases in vascular conductance of diaphragm, adrenal gland, cerebral hemispheres, cerebellum and brain stem, the resultant increases in blood flow being larger in the unanaesthetized rats. 6. It is proposed that in unanaesthetized, as in anaesthetized, rats the regional dilator responses predominantly reflect the local dilator effects of tissue hypoxia. Possible dilator factors are considered.

Passage of microspheres through vessels of normal and split hydronephrotic rat kidneys

Microspheres (15 micron) were injected intracardially in rats. By means of in vivo microscopy of the split hydronephrotic kidney microcirculation, the passage of microspheres through renal blood vessels was analyzed. Additionally, three sets of experiments were conducted, one consisting of rats with normal kidneys, one of rats with hydronephrotic kidneys, and one of rats with hydronephrotic kidneys under vasodilation. In vivo microscopic as well as histological studies show that the passage of 15-micron microspheres is dependent on the postinjection interval. Microspheres are capable of locally dilating preglomerular vessels and moving towards the glomeruli. Therefore, estimates of preglomerular vessel diameters with microsphere experiments ought to be controlled by intravital microscopy.

Contrast ultrasonography of the kidney: a new method for evaluation of renal perfusion in vivo

Assessment of the effects of pharmacologic agents on renal blood flow (RBF) is clinically important in many disease states, including hypertension and congestive heart failure. However, because of the complexities of RBF, quantitation in vivo has been technically difficult. This study demonstrates the utility of ultrasound imaging of the kidney combined with injection of a sonicated radiocontrast solution (Renografin-76) for the assessment of regional renal blood flow. The technique uses a suspension of uniform microbubbles (diameter 4.4 +/- 2.8 micron), which when injected directly into the descending aorta are distinctly visualized by renal ultrasound. Five dogs were studied. Catheters were placed in the descending aorta for injection of sonicated Renografin and in the renal artery for drug infusions. Data were collected before and during intrarenal artery infusions of bradykinin and norepinephrine. Total RBF was measured by electromagnetic flowmeter. Video density time curves were generated for comparable segments of the outer renal cortex and fit to a monoexponential decay curve. This allowed calculation of the mean exponential decay index (t1/2). An increase in t1/2 paralleled decreased renal perfusion (i.e., longer washout of contrast material). The opposite was true for a decrease in t1/2. Bradykinin increased RBF from 134 +/- 26 to 249 +/- 19 ml/min (p less than .01 vs control), and norepinephrine decreased RBF from 130 +/- 25 to 51 +/- 17 ml/min (p less than .01 vs control).(ABSTRACT TRUNCATED AT 250 WORDS)

Tissue blood flow and localization of arteriovenous anastomoses in pigs with microspheres of four different sizes

Using microspheres of 10, 15, 25 and 35 micron diameters we have compared blood flows to a large number of tissues and the complete distribution of common carotid arterial blood in an attempt to localize the site of arteriovenous shunting in anaesthetized pigs. Blood flow values obtained with the spheres of the four sizes were similar in the brain, heart, kidneys, skeletal muscles, stomach, small and large intestines, spleen, adrenals, liver, bones, fat and salivary glands. In the ears and skin from several regions, blood flow measured with 35 micron spheres was substantially higher than those measured with smaller spheres. Blood flow pattern in the eye and tongue was such that 10 micron flow value was moderately less and the 25 and 35 micron values were only slightly higher than the corresponding 15 micron value. These data indicate that a considerable number of arteriovenous anastomoses, large enough to let microspheres of up to 25 micron pass through, are present in the ears and skin. Only smaller arteriovenous anastomoses may be present in the eyes and tongue. This conclusion is supported by the observation that 5-hydroxytryptamine, which causes constriction of arteriovenous anastomoses, negated the difference in the blood flows measured with 15 and 35 micron spheres in the ears and skin.

The radiolabeled microsphere technique in gut blood flow measurement--current practice

Measurement of blood flow to the gut has become an integral part of the physiologic study of the gastrointestinal tract. While many methods have been utilized in measuring tissue blood flow, the one most often practiced today is dependent on injection of radioactively labeled microspheres. The theoretical basis of the microsphere technique is analogous to that of the indicator-dilution method. A bolus of microspheres suspended in a suitable vehicle is injected into the left atrium or left ventricle where they mix uniformly with the oxygenated blood. They are then distributed via aortic blood flow to the capillary beds within each organ in proportion to the volume of microsphere-containing blood. Technical aspects of tissue processing, gamma energy detection, and gamma spectrum analysis are reviewed. Sources of experimental error and techniques for their reduction are also discussed.

The effect of a natriuretic atrial extract on renal haemodynamics and urinary excretion in anaesthetized rats

1. An extract of cardiac atrial tissue, when injected intravenously into anaesthetized rats, caused a large and rapid increase in renal excretion of sodium chloride. 2. The renal response to atrial extract was associated with increases in total and medullary blood flow in the kidney, as measured by microsphere and albumin uptake methods, respectively. 3. The data suggest that these changes in renal haemodynamics may contribute to, but are unlikely to be the complete cause of, the natriuresis and chloriuresis following injection of atrial tissue extract.

Distribution of blood flow in the dog kidney. IV. Reversed net inward postglomerular capillary flow in the cortex after blocking interlobular arteries by 50 mum microspheres

Simultaneous measurement of glomerular flow by 15 mum microspheres (Ms) and postglomerular capillary flow by 125I-iodoantipyrine (I-Ap) suggest that about 10% of total RBF flow inward through the entire cortex in the postglomerular capillaries of the dog kidney. This flow fraction might be variable (Clausen et al. 1978, 1980) and perhaps even reversible. To test this possibility we injected 50 mum Ms into the renal artery in order to obstruct interlobular arteries and produce a selective reduction of outer cortical glomerular blood flow and postglomerular pressure. The 50 mum Ms reduced total RBF by 50%. In the outer cortex, postglomerular flow measured by I-Ap was significantly less reduced than glomerular flow as measured by 15 mum Ms: Whereas the inward flow fraction from inner cortex to the medulla was maintained, about 5% of RBF now drained from midcortex to outer cortex. This observation support the theory of a variable net postglomerular capillary flow of radial direction in the cortex of the dog kidney.

Reliability of the measurement of intrarenal haemodynamics in the dog, as determined by the radioactive microsphere technique

In the anaesthetized dog total renal blood flow (RBF) and its intrarenal distribution were investigated by the radioactive microsphere technique under control conditions and after various experimental interventions. (i) In five control series performed within the last four years, there was a small but significant scatter in total RBF, due entirely to changes in inner cortical (IC) perfusion, while outer cortical (OC) perfusion proved to be constant. (ii) Repeated measurements in the same dog, performed after 1 h interval revealed constancy of total RBF with some inward shifting in cortical perfusion. (iii) Surgical intervention or manipulation of the kidney did not alter total RBF but led to an increase in IC, compensated by a decrease in OC perfusion (iv) The possible role of local intrarenal hormones (angiotensin and prostaglandin) in the above changes is discussed.

Effects of renal and hepatic venous congestion on renal function in the presence of low and normal cardiac output in dogs

We investigated the effect of acute renal vein and hepatic vein hypertension induced by partial balloon-occlusion of the abdominal inferior vena cava (AIVC-O) and the thoracic inferior vena cava (TIVC-O) on systemic and renal hemodynamics and renal function in 13 dogs anesthetized with pentobarbital. When a renal vein pressure of 13 cm H2O was induced by AIVC-O, cardiac output, stroke volume, central venous pressure, renal blood flow, and renal function (GFR, free water clearance, osmolar clearance, urine output, urinary sodium excretion, fractional sodium excretion) decreased significantly. When systemic hemodynamics were restored to control values by transfusion of autologous blood (mean of 9 ml/kg body weight) while renal vein pressure was kept elevated, renal function also was restored. A hepatic venous pressure of 13 cm H2O then was induced by TIVC-O. The effects on systemic hemodynamics and renal function were very similar to those observed during AIVC-O. When systemic hemodynamics were restored to control values by transfusion (mean of 9 ml/kg), while hepatic venous hypertension was maintained by TIVC-O, renal function also was restored. Despite significant changes in natriuresis and diuresis, intrarenal blood flow distribution, as determined by the radioactive microsphere technique, remained essentially unchanged throughout. We conclude that renal and hepatic congestion induced by partial AIVC-O and TIVC-O do not, per se, alter renal function significantly.

Validation studies for the use of the microsphere method in cats and young minipigs

Radioactive microspheres are suitable for measuring cardiac output, its distribution and organ blood flow if certain criteria are met. Cardiac output may be determined with the reference flow method if microspheres do not recirculate. In case 10 micron microspheres were extracted completely by the lungs. The use of microspheres for the determination of cardiac output is therefore not limited by recirculation of microspheres down to this size. Under baseline conditions we found no preferential streaming with 50 micron spheres in young minipigs and with 25 and 15 micron spheres in cats At high cardiac output values induced by the administration of 0.4 mg/kg of Dihydralazine in cats, 25 micron but not 15 micron microspheres showed a small, non significant tendency to stream preferentially into the upper body. Thus, under rapid flow conditions 15 micron microspheres may be preferable to larger ones from the rheological point of view. Under baseline conditions the distribution of cardiac output to a wide range of organs was very similar when comparing 25 and 15 micron microspheres in cats and 50 and 15 micron microspheres in minipigs, whereas 10 micron microspheres were poorly extracted by most organ in cats. 15 micron microspheres were found to be suitable for the determination of cardiac output and its distribution in both species provided that bronchial and arteriovenous shunt flows can be neglected.

Comparative effects of catecholamines in cardiac tamponade: experimental and clinical studies

In experimental cardiac tamponade, catecholamines improve hemodynamic variables. To determine whether hemodynamic changes result in increased blood flow to critical organs, tamponade was produced in nine spontaneously breathing, anesthetized dogs. Infusion of dopamine, isoproterenol or norepinephrine doubled cardiac output, but only norepinephrine increased mean arterial pressure. All catecholamines increased blood flow to the myocardium, but not to the brain or kidney. Isoproterenol caused a significant decrease in the endocardial/epicardial blood flow ratio, which was shown to be due to tachycardia. To determine whether catecholamines increase cardiac output and mean arterial pressure in patients with tamponade, eight patients with tamponade due to neoplasms were studied before therapeutic pericardiocentesis. Cardiac output increased only 50 percent with dopamine and isoproterenol and not at all with norepinephrine. Cardiac filling pressure did not decrease with isoproterenol or dopamine, as in experimental tamponade. Only norepinephrine increased mean arterial pressure. Thus, although catecholamines improve hemodynamics in experimental tamponade, the heart is the only critical organ to which blood flow is improved. The hemodynamic benefits of catecholamine administration to patients may be more limited than previous experimental studies have suggested.

Microsphere size and determination of intrarenal blood flow distribution in the rat

The influence of microsphere size upon the estimation of cardiac output (CO), renal blood flow (RBF) and its cortical distribution (ICBFD) was evaluated by simultaneous injection of 8.5 +/- 0.8 micrometer (SD) and 12.7 +/- 1.7 micrometer (SD) spheres in control conditions and after hemorrhagic hypotension (HH rats). The values of CO and RBF were unaffected whilst the ratio of flow to outer and inner halves of cortex (OCF/ICF) was 32% higher with 12.7 micrometer than with 8.5 micrometer spheres in both groups. Microscopic analysis of cleared kidneys slices confirmed that large spheres were more concentrated in outermost and less concentrated in innermost glomeruli than small spheres. In addition, the ratio of sphere number per outermost to that per innermost glomerulus (fs/fjm), and approximation of glomerular blood flow distribution was 1.74 and 1.76 with large spheres and 0.98 and 1.06 with small spheres in control and HH rats respectively. It is concluded that the artifact due to sphere size was not minimized in low flow conditions (HH rats) and that 8.5 micrometer spheres may be a more realistic marker of glomerular blood flow distribution in the rat than 12.7 micrometer spheres.

Renal blood flow distribution at varying perfusion pressure in the alloperfused dog kidney

Tissue blood flow (TBF), its percent distribution and glomerular blood flow (GBF) were measured using labelled microspheres 15 micrometer in diameter (M) and chicken red blood cells (CRBC) at perfusion pressures (PP) of 17.3, 12.8 and 8.0 kPa (130, 95 and 60 mm Hg) in isolated alloperfused dog kidneys. Renal blood flow (RBF) was never interrupted during the isolation. Experiments with M showed a marked inequality of the tissue blood flow in different parts of the renal cortex at a constant PP of 17.3 kPa. TBF was highest in the outermost quarter and lowest in the juxtamedullary one. Using CRBC, a homogeneous TBF was observed in the outer 3/4 of the renal cortex with a lower flow in the innermost quarter. With M, a typical percent "redistribution" of TBF and GBF into the inner cortical regions was indicated during PP reduction. With CRBC, this phenomenon was observed only at PP below the range of RBF autoregulation (8.0 kPa) and was much less conspicuous than with M. The smaller size and higher elasticity of CRBC as compared with M, may result in a more realistic reflection of cortical blood flow distribution. The GBF of outermost superficial glomeruli decreases, even with CRBC, with each PP reduction, the difference exhibiting only a 5% significance level. The lower limit of BF autoregulation in these glomeruli seems to be somewhat higher than that of total RBF autoregulation.

The measurement of glomerular blood flow in the rat kidney: influence of microsphere size

1. Radioactively labelled microspheres were used to determine glomerular blood flow in glomerular populations with distinct vascular characteristics. Two batches of microspheres (15 +/- 5.0 micrometer diameter and 7.0--10 micrometer diameter) were utilized. 2. The results show that the larger microspheres overestimate the superficial glomerular blood flow (414 +/- 61 nl/min, mean +/- s.e.m.) and underestimate the deep glomerular blood flow (98 +/- 10 nl/min), when compared with the data obtained with 7.0--10 micrometer diameter microspheres (317 +/- 30 nl/min and 209 +/- 23 nl/min, respectively). 3. The rheological artefact associated with the use of larger microspheres is confirmed by finding an uneven size distribution of microspheres lodged in the glomeruli. In each of three experiments, the mean diameter of 200 microspheres lodged in the superficial glomeruli (16.43 +/- 0.27 micrometer, 15.87 +/- 0.23 micrometer and 16.58 +/- 0.27 micrometer) was significantly greater than that found in the deep glomeruli (15.36 +/- 0.15 micrometer, 15.25 +/- 0.21 micrometer and 15.73 +/- 0.24 micrometer; P less than 0.01, less than 0.05 and less than 0.01, respectively). No such difference was detected when the 7.0--10 micrometer spheres were used. 4. Glomerular blood flow can be measured at all depths of the rat's cortex and the demonstrated rheological artefact associated with use of the larger spheres is circumvented with the use of 7.0--10 micrometer microspheres.

Renal function and intrarenal hemodynamics in acutely hypoxic and hypercapnic rats

On the basis of microsphere distribution, inert gas washout, and standard clearance data, the effects of acute hypoxia and hypercapnia on the kidney were studied in anesthetized, mechanically ventilated rats. Moderate hypoxia (mean PO2, 48 mm Hg) did not significantly change diuresis, GFR, and tubular sodium rejection. Due to a decrease in renal vascular resistance (R) from 40.1 to 31.8 mm Hg ml-1 min, mean renal blood flow stayed constant in spite of a significant drop in mean arterial blood pressure. Hypoxic changes in R were not accompanied by significant changes in intrarenal distribution of blood flow (IDBF). In severe hypoxia (PO2 less than 45 mm Hg) with oliguria and marked arterial hypotension, R was the lowest of all groups (28.8 mm Hg ml-1 min). Hypercapnia did not significantly change the renal excretory parameters, although an increase in R (without change in IDBF), together with a decrease in MAP caused a marked drop in mean renal blood flow. From these studies we conclude: 1) in the anestheized rat, acute hypoxia caused significant changes in intrarenal hemodynamics without changes in excretory function, 2) hypoxic renal vasodilation persists even in severe hypotension with oliguria and anuria, 3) in acute hypoxia and hypercapnia, changes in renal blood flow and renal vascular resistance are not accompanied by significant changes in IDBF.

The impact of in-situ balloon occlusion of the renal artery and hypothermic perfusion on renal blood flow

Unilateral renal blood flow was evaluated in-situ in 13 dogs by cineangiodensitometry and microsphere distribution studies before and after intermittent balloon occlusion with and without hypothermic perfusion of one kidney. The contralateral kidney served as control. No significant difference in renal blood flow and vascular resistance was noted before, and 5, 30 and 60 minutes after unilateral intra-arterial manipulation. Compartmental flow distribution studies in 5 dogs revealed no evidence of alteration of intra-renal haemodynamics. In a clinical pilot study, unilateral renal blood flow measured by cineangiodensitometry showed no change of clinical significance 5 and 60 minutes after intraluminal balloon occlusion of the renal artery for 60 seconds.

Quantification of pulpal blood flow in developing teeth of dogs

Pulpal blood flow was determined in 32 dogs ranging in age from 6 weeks to 18 months by the isotope fractionation method incorporating diffusible and nondiffusible tracers. Dogs were placed into selected age groups by the developmental status of the canine teeth. For the teeth sampled, the maxillary first, second, and third incisors along with the canines and first molars, pulpal blood flow was determined to be not different in teeth at various developmental stages. For some dental pulps, alveolar mucosa, and bone, the tracers were not determining equivalent blood flows. Because of incomplete trapping of the 7- to 10 mu microspheres and the flow limitation of 86Rb, the 15 mu spheres would appear to be a reliable indicator of "total" blood flow to pulpal tissues. However, in alveolar mucosa and bone, and 15 mu microspheres may not be completely trapped and thus, may underestimate blood flow to these tissues. Within the age range of these dogs, tissue blood flow was not dependent upon the stages of oral development.

Blood flow measurements with radionuclide-labeled particles

When appropriately and correctly applied, the microsphere technique is relatively simple and extremely accurate. Distribution patterns, both of total systemic arterial blood flow or venous return as well as within specific organs, can be measured. Several techniques have been applied to quantitate flow using microspheres; the reference sample method is extremely simple and by far the most accurate of all. Collection of venous effluent is perhaps more accurate but requires extensive surgery and is almost certainly the least physiologic. Other methods used for quantitation, such as bolus injections of indocyanine green dye or in fusions of diffusable indicators, are considerably less accurate and therefore significantly reduce the reliability of the microsphere technique. Selection of the appropriate size microspheres allows for definition of arteriovenous anastomoses as well as the measurement of organ blood flows and distribution of blood flow within those organs. In most instances, smaller microspheres (15mu diameter or 8-10mu diameter) have significant advantages over larger ones. They are distributed more like red cells, obstruct less of the vascular bed, are less variable in size, and can be given in significantly greater numbers. This latter point is important, since the statistical criteria need to be satisfied and the use of small spheres allows for the more reliable measurement of blood flow to small organs or to small regions of organs.

Renal hemodynamics in the perinatal period. A study in lambs

The perinatal changes in renal hemodynamics have been studied in lambs. Eleven of the lambs were exteriorized, but maintained on placental circulation (fetal lambs). Eight of the lambs were delivered with cesarean section and studied immediately after clamping of the cord (newborn lambs). Nine lambs were delivered spontaneously and studied during the first 9 days of life. Renal blood flow (RBF) was determined by the microsphere method using a sample drawn from the iliac artery as the reference flow. The filtering capacity of the nephrons was evaluated after ferrocyanide injection and dissection of the nephrons. Total RBF did not seem to change much at birth but increased in relation to kidney weight during the first postnatal week. Clamping of the cord did, however, result in a change in intrarenal blood flow distribution, so that in the newborn lambs relatively more of the blood flow was perfusing the outer cortical region. During the first postnatal week there was a slight, but insignificant further relative increase in outer cortical blood flow. The relative increase in outer cortical blood flow at birth was accompanied by an increased frequency of filtering superficial nephrons from 22 to 77%. Practically all juxtamedullary nephrons were filtering before birth. Three days postnatally 98% of the superficial and 100% of the juxtamedullary nephrons were filtering.

The effect of indomethacin, 6-hydroxydopamine, saralasin, and hemorrhage on renal hemodynamics

This report describes the response of the renal circulation to prolonged hemorrhagic hypotension and reinfusion of blood, and to the effect of a variety of drugs (saralasin, indomethacin, and 6-hydroxydopamine, 6-OH-DA). Plastic microspheres were used to measure blood flow perfusing the entire kidney and also the outer cortex, inner cortex, and medulla of the kidney. Cardiac output was determined with a Doppler flow probe, and total and regional flows were calculated. Redistribution of blood flow from outer cortex to inner cortex and medulla occurred during hemorrhage and after administration of saralasin and 6-hydroxy-dopamine, while indomethacin did not alter intrarenal flow distribution. Total renal flow increased after reinfusion of blood and saralasin, but decreased after indomethacin. It did not change after 6-hydroxydopamine. The results demonstrate that changes in total and intrarenal flow occur independently and are probably due to different mechanisms.

Effect of steric restriction on the intracortical distribution of microspheres in the dog kidney

The effect on the intracortical distribution of microspheres and radioactivity caused by steric hindrance of the free movement of spheres into afferent arterioles are described by two mathematical models. The results are compared with corresponding experimental data obtained in six kidneys from normotensive dogs. The first model (A) assumes that spheres are distributed as blood flow, regardless of their size, except for those having diameters greater than that of an afferent arteriole and which do not enter this vessel. The second model (B) includes the Ferry correction. The experimental data show that the percent recovery of spheres with diameters of 20-25 mum was significantly greater in the outer cortex and significantly less in the juxtamedullary cortex than recovery of the smaller spheres, and that the distribution of spheres with diameters of 10 mum to about 17 mum seems uninfluenced by the sphere size. The experimental results we have obtained fit best with model A. We found that according to both models steric restriction is a factor of major importance in relation to the intracortical distribution of spheres, and the analysis shows that the blood flow in the inner part of the renal cortex is grossly underestimated by the method of isotope labeled microspheres when diameters of 15 +/- 5 mum are used in the dog. Furthermore we found that dilation of the afferent arterioles will change the steric hindrance so that a redistribution of spheres and radioactivity may occur without any redistribution of blood flow. It is suggested that the results interpreted as redistribution of blood flow can be explained as due to altered steric hindrance alone, i.e., as a methodological artifact.

Diameter of the afferent arteriole in the dog kidney estimated by the microsphere method

Microspheres with diameters of from 10 to 30 mum were injected into the renal arteries of three anesthetized dogs. The six kidneys were studied by light microscopy. The diameters of the spheres trapped in the afferent arterioles and of all spheres recovered in the kidneys were recorded. On the basis of the distribution of diameters in these two populations of spheres, the average diameter of the afferent arteriole and the distribution of the afferent arteriolar diameters were estimated. The average diameter of the afferent arterioles was 16.3 mum (S.D. 2.2 mum), without any difference between three cortical layers of equal thickness. The mean diameter of spheres trapped in the interlobular arteries was 25.7 mum (S.D. 2.6). It is suggested that the pressure drop along some interlobular arteries may be of physiological importance, affecting the autoregulation of blood flow in the renal cortex.

Visualization of chicken red blood cells in capillaries by immunofluorescence

Chicken red blood cells labelled with specific rabbit antiserum were used for the demonstration of cortical distribution of blood in the dog kidney by means of direct immunofluorescence. Immunization and labelling techniques are described.