The renal microcirculation. The kidney is divided into a cortex and a medulla. The cortex contains an arterial network, glomeruli, a dense peritubular capillary plexus, and a venous drainage system. In the cortex, arcuate arteries, which run parallel to the surface, give rise to cortical radial (interlobular) arteries radiating toward the surface. Afferent arterioles originate from the cortical radial arteries at an angle that varies with cortical location. Blood is supplied to the peritubular capillaries of the cortex from the efferent flow out of superficial glomeruli. Blood is supplied to the medulla from the efferent flow out of juxtamedullary glomeruli. Efferent arterioles of juxtamedullary glomeruli give rise to bundles of descending vasa recta in the outer stripe of the outer medulla. In the inner stripe of the outer medulla, descending vasa recta and ascending vasa recta returning from the inner medulla run side by side in the vascular bundles, allowing exchange of solutes and water. The descending vasa recta from the bundle periphery supply the interbundle capillary plexus of the inner stripe, whereas those in the center supply blood to the capillaries of the inner medulla. Contractile pericytes in the walls of the descending vasa recta regulate flow. DVR, descending vasa recta.AVR, ascending vasa recta. (Used with permission from Pallone TL, Zhang Z, Rhinehart K.Am J Physiol Renal Physiol 2003;284:F253–F266.)
Nephrons are categorized according to the locations of their renal corpuscles in the cortex: (1) In superficial cortical nephrons, renal corpuscles are located within 1 mm of the capsular surface of the kidneys; (2) in midcortical nephrons, renal corpuscles are located, as their name implies, in the midcortex, deep relative to the superficial cortical nephrons but above (3) the juxtamedullary nephrons, which, as mentioned previously, have renal corpuscles located just above the junction between cortex and medulla. One major distinction among these 3 categories of nephrons is the length of Henle’s loop. All superficial cortical nephrons have short loops, which make their hairpin turn above the junction of outer and inner medulla. All juxtamedullary nephrons have long loops, which extend into the inner medulla, often to the tip of a papilla. Midcortical nephrons may be either short looped or long looped. The additional length of Henle’s loop in long-looped nephrons is due to a longer descending thin limb and the presence of an ascending thin limb. Finally, the beginning of the thick ascending limb marks the border between the outer and inner medulla; in other words, the thick ascending limbs are found only in the cortex and outer medulla.
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