Figure 1

Figure 1. From: Renal Medullary Oxidative Stress, Pressure-Natriuresis, and Hypertension.

This portrays the proposed relationship between arterial pressure and sodium delivery to the medullary thick ascending limb (mTAL) of the kidney. The impact of this relationship on the NO and superoxide (O2·−) systems and the subsequent cross-talk between the tubules and the vasa recta is depicted. When NO is produced by the mTAL and diffuses to the pericytes of the vasa recta, medullary blood flow (MBF) increases thereby reducing sodium reabsorption and shifting the renal function curve to the left. However, when NO is present at low levels, O2·− then diffuses to the vasa recta and MBF is reduced, resulting in an increase of sodium reabsorption shifting the renal function curve to the right. These relationships can in turn be modulated by factors that stimulate or reduce nitric oxide synthase (NOS) and NAD(P)H-oxidase activity such as angiotensin II (Ang II).

Allen W. Cowley. Hypertension. ;52(5):777-786.

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