Figure 64

Mechanism of failure of autoregulation in a glomerulus from a damaged kidney. A, Baseline. B, Increased perfusion pressure. To compensate for a partial loss of function, surviving glomeruli undergo adaptive changes to increase the filtration rate. These include a reduction in afferent (RA) and efferent (RE) arteriolar resistances, tending to increase renal plasma flow and the glomeru-lar filtration rate. In this setting, an increase in mean arterial pressure (MAP) is transmitted directly to the glomerular capillaries, resulting in glomerular capillary hypertension, increased protein filtration, and hemodynamically mediated capillary injury. Pqc— glomerular capillary hydraulic pressure.

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