Examination of ischaemic kidneys reveals changes which generally correlate well with the pathophysiology of renal ischaemia. Although there is an association between renal ischaemia, juxtaglomerular granulation and hypertension, notable exceptions are seen from time to time. Improved methods of identification of the contents of juxtaglomerular granules may provide better methods of prediction of those patients likely to benefit from nephrectomy for hypertension associated with renal ischaemia. Further studies of the function of mesangial cells and of the smooth muscle cells of the juxtaglomerular apparatus promises to provide information to explain the collapse of glomerular tufts, and hence of impaired glomerular filtration, following ischaemia.
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