Clinical Investigation

Kidney International (1972) 2, 224–230; doi:10.1038/ki.1972.98

Intrarenal vascular changes with age and disease

Eisuke Takazakura1, Norio Sawabu1, Akira Handa1, Akira Takada1, Akira Shinoda1 and Jugoro Takeuchi1

1First Department of Internal Medicine, School of Medicine, Kanazawa University, Kanazawa, Japan

Correspondence: Dr Jugoro Takeuchi, The First Department of Internal Medicine, Kanazawa University, Kanazawa, Japan.

Received 28 December 1971; Revised 7 July 1972.

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Abstract

Intrarenal vascular changes with age and disease. The effect of age and disease on extraglomerular medullary vascular pathways was studied. The intrarenal arterial patterns of 63 autopsied kidneys were examined by microangiographic and histologic techniques. The arteriole-glomerular (A–G) units were classified into two basic types, i. e., cortical and juxtamedullary, on the basis of the appearance of the efferent arterioles. The juxtamedullary type may depart from its basic pattern to become continuous, i. e., the afferent and efferent arterioles form a direct connection. The frequency of this alteration (the continuity index) increased in proportion to age in normal kidneys and to the degree of damage in diseased kidneys. In contracted kidneys, the cortical arterial tree was destroyed by obliteration of the cortical A–G units whereas the medullary A–G units became continuous and were relatively well preserved, thus maintaining the medullary circulation.

Modifications vasculaires intrarénales en fonction de l'âge et de l'atteinte pathologique. L'effet de l'âge et de l'atteinte pathologique sur les voies vasculaires extra glomérulaires a été étudié. Les modèles artériels intrarénaux de 63 reins d'autopsie ont été examinés par des techniques microangiographique et histologique. Les unités artériole-glomérule (A–G) ont été classées dans deux catégories principales, corticale et juxta médullaire, sur la base de l'aspect des artérioles efférentes. Le type juxta médullaire peut différer de son aspect habituel et devenir continu, c'est-à-dire que les artérioles afférente et efférente forment une communication directe. La fréquence de cette altération (l'index de continuité) augmente en fonction de l'âge dans les reins normaux et en fonction de l'intensité de la destruction dans les reins malades. Dans les reins diminués de volume l'arbre artériel cortical est détruit par l'oblitération des A–G corticales alors que les A–G médullaires deviennent continues et relativement bien préservées, maintenant ainsi une circulation médullaire.

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