In hypertension the pressure natriuresis set point is shifted to a higher pressure due to an increase in both renal vascular resistance and sodium (Na) reabsorption. The afferent arterioles (Af-Arts) and efferent arterioles (Ef-Arts) account for most renal vascular resistance; they control glomerular filtration rate (GFR) and peritubular pressure, and, consequently, renal function. Af-Art and Ef-Art resistance is regulated by factors similar to those in other arterioles and also by tubuloglomerular feedback (TGF). TGF operates via the macula densa, which senses increases in sodium chloride (NaCl) and sends a signal that constricts the Af-Art and dilates the Ef-Art. In the outer renal cortex, the connecting tubule (CNT) returns to the glomerular hilus and contacts the Af-Art. This morphology is compatible with cross-talk between the CNT and Af-Art, so-called connecting tubule glomerular feedback (CTGF). Our studies show that increasing NaCl delivery to the CNT results in Af-Art dilatation that can be blocked by inhibitors of Na transport. We believe cross-talk between the CNT and Af-Art is a novel mechanism that may contribute to regulation of renal blood flow and GFR.
KeywordsAfferent arteriole; Macula densa; Connecting tubule; Tubuloglomerular feedback; Na transporterThe afferent arteriole (Af-Art) accounts for most renal vascular resistance. It controls glomerular filtration rate (GFR) and peritubular pressure, and consequently renal function. The hormonal and neural influences on vascular resistance that participate in the control of blood flow and GFR have been fairly well defined. Anatomical contact between the end of the thick ascending limb of the loop of Henle and its own glomerulus was described for the first time more than 100 years ago. In each nephron of the mammalian kidney, the tubule returns to the hilus of the parent glomerulus, forming the juxtaglomerular apparatus (JGA). The JGA is made up of (a) a plaque of specialized tubular epithelial cells called the macula densa; (b) the extraglomerular mesangium; and (c) the glomerular Af-Art and efferent arteriole (Ef-Art). This anatomical connection is thought to be crucial for tubuloglomerular feedback (TGF) control of GFR [1][2][3]. Therefore, Af-Art resistance is regulated not only by factors similar to those in other arterioles but also by the macula densa. TGF describes a functional connection between the tubular epithelium at the site of the macula densa and the underlying smooth muscle cells of the Af-Art and Ef-Art. An increase or decrease in sodium chloride (NaCl) concentration in the luminal fluid at the macula densa cells activates arteriolar constriction or dilation, respectively, and hence alters single-nephron GFR (SNGFR).Experimental studies of TGF began with the microinjection experiment designed and initiated by Klaus Thurau [4]. After the proximal segments belonging to the same nephron had been © IPNA 2008 Correspondence to: YiLin Ren, yren1@hfhs.org. Thomson and Blantz [9] evaluated the ability of TGF to stabilize tubula...