[Renal medullary circulation: morphological characteristics of vessels and their organization].

The blood vessels of the renal medulla have several particular features. The supplying vessels of the renal medulla are the efferent arterioles of the juxtamedullary glomeruli. Thus, the blood supply is entirely postglomerular. The distribution of the blood within the renal medulla is effected by the descending vasa recta. Descending and ascending vasa recta form the vascular bundles. Descending vasa recta leave the bundles at any level of the medulla to feed the adjacent capillaries; the longest descending vasa recta reach the papillary tip. The capillary plexus are differently developed. A dense capillary plexus is present only in the inner stripe of the outer medulla. In the inner medulla the capillary plexuses are poorly developed. At these sites ascending recta contribute to the capillarisation. The ascending vasa recta originate from capillaries at any level of the medulla and ascend without joining together towards the intrarenal veins at the cortico-medullary border. They are capillary vessels with wide lumina. Within the outer stripe of the outer medulla these vessels are very narrowly associated with the tubules; interstitial spaces are very poorly developed at this site. These relationships are interpreted as a possible weak point of the medullary circulation in pathological situations.