In normal conditions, the kidney receives 20%-25% of the cardiac output (VB). Thus, it not surprising that several blood-borne endogenous or exogenous nephrotoxic substances (radiocontrast media, amynoglycosides, pigments, immunocomplexes etc.) can cause a disturbance of the renal function, which is principally be related to the damage of the renal microvascular network and possibly leading to acute renal failure (ARF). However, the term “renal vascular injury” usually indicates the pathophysiologic consequences of the shortage of renal blood supply occurring in many clinical settings, including trauma and hemorrhage, surgical interventions and burns, ultimately leading to the occurrence of the prerenal ARF. Due to several pathophysiological factors, the renal medulla is particularly at risk of ischemic damage (1), and the occurrence of ARF is usually associated to extensive anatomofunctional damage of the deepest region of the kidney.


Acute Renal Failure Renal Blood Flow Renal Medulla Thick Ascendent Limb Nephrotoxic Agent 
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© Springer-Verlag Italia, Milano 1996

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  • G. Berlot

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