Renal Endothelial Dysfunction in Acute Kidney Ischemia Reperfusion Injury
David P. Basile and Mervin C. Yoder
Affiliation: Department of Cellular & Integrative Physiology, Indiana University School of Medicine, 635 Barnhill Drive, Med Sci 334, Indianapolis, IN 46202, USA.
Keywords: Angiogenesis, chronic kidney disease, inflammation, rarefaction, repair.
Acute kidney injury is associated with alterations in vascular tone that contribute to an overall reduction in
GFR. Studies in animal models indicate that ischemia triggers alterations in endothelial function that contribute
significantly to the overall degree and severity of a kidney injury. Putative mediators of vasoconstriction that may
contribute to the initial loss of renal blood flow and GFR are highlighted. In addition, there is discussion of how intrinsic
damage to the endothelium impairs homeostatic responses in vascular tone as well as promotes leukocyte adhesion and
exacerbating the reduction in renal blood flow. The timing of potential therapies in animal models as they relate to the
evolution of AKI, as well as the limitations of such approaches in the clinical setting are discussed. Finally, we discuss
how acute kidney injury induces permanent alterations in renal vascular structure. We posit that the cause of the sustained
impairment in kidney capillary density results from impaired endothelial growth responses and suggest that this limitation
is a primary contributing feature underlying progression of chronic kidney disease.
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