Intrarenal Blood Flow in Congestive Heart Failure

Intrarenal blood flow distribution was measured by the 133xenon washout technic in 10 patients with heart disease who were studied at time of left and right heart catheterization. Renal washout curves were analyzed by computer using a weighted least-squares nonlinear regression technic. In three patients with heart disease without edema the compartment I blood flow rates (outer cortex) were not significantly different from those found in nine normal kidney donors. In seven patients with hemodynamic evidence of heart failure and clinical edema the compartment I flow rates were significantly lower than those of the normal control group and of a group of sodium-depleted hypertensive patients. The rate constants of isotope removal from more central regions of the kidney (compartments II and III) were not depressed to a similar degree. Infusion of furosemide into the renal artery induced diuresis in eight studies which was accompained by preferential increases in compartment I flow rates in six. The data suggest that preferential vasoconstriction of renal cortical vessels may contribute to increased sodium retention by the kidneys and to edema formation in patients with congestive heart failure.