Flow-dependent endothelial function and kidney dysfunction.

The vascular endothelium constantly integrates biomechanical and humoral signals and responds by secreting or metabolizing multiple factors that act in an autocrine or paracrine manner on the vasculature and adjacent tissues. Several studies have documented the effects of blood flow on renal endothelial cells and its effects on the pathophysiology of the kidney. In contrast, less is known about the effects of acute flow cessation on renal endothelium and kidney function. Here we review our current knowledge on flow cessation, endothelial function, and kidney dysfunction in the context of two clinically relevant settings, namely, the no-reflow phenomenon, observed during periods of renal warm ischemia, and the cold storage of kidney transplants.