A Method for Visualization of Kidney Blood Vessels Applied to Studies of the Crush Syndrome.

Abstract

A fluorescent dye, Thio-flavin-S, is used in outlining the vessels and glomeruli of the kidneys of rabbits under normal and crush conditions. The crush is produced by the application of a wire tourniquet around the left hind leg of a rabbit for 4.5 hrs. The dye is given intraven., 1 cc./kg. of body wt. of a 4% soln. The kidneys are removed a few sec. after the injn., sliced in fresh condition, and examined in glycerine under u.-v. light. Fluorescence is seen in all vessels through which blood was flowing at the time of injn. The removal of the kidneys does not interfere with the distr. of dye since this is already in the vessel walls. The blood itself shows no fluorescence. The interlobular arterioles and the glomeruli of the cortex are fluorescent in both normal and crush animals. There is a bright fluorescence of the medulla of the kidneys from normal rabbits contrasting with only a very slight fluorescence of the medulla of the kidneys of crush rabbits. No exclusion of the cortex by the renal circulation, as seen by Trueta in the crush rabbits, can be demonstrated. Urine output for 1-2 hrs. after removal of the tourniquet is on the avg. much higher in the crush rabbits. P.S.P. excretion is decreased and delayed in the crush animals. To see if epinephrine will cause the distr. of blood flow indicated by Trueta in the crush, 3.7 cc. of 1:10,000 epinephrine/kg. was given intraven. to normal and crush rabbits. The result was vaso-constriction and diminution of the blood flow generally, but no by-pass of the cortex could be demonstrated. The changes appear to be due to a decrease in the blood flow in the crush rabbits, particularly through the medulla, caused by a drop in systemic blood pressure, most likely combined with constriction of the efferent arterioles.