Modeling exchange of plasma proteins between microcirculation and interstitium of the renal medulla

In the absence of evidence for lymphatics in the inner medulla of the kidney, it has been proposed that plasma proteins are cleared by convection out of the medullary interstitial fluid (ISF) directly into the ascending vasa recta (AVR). To clarify this hypothesis we have developed a mathematical model of the microvascular exchange of fluid, plasma proteins, and small solutes among the descending vasa recta (DVR), the AVR, and the ISF. The model represents the DVR and AVR as limbs of a countercurrent exchange loop separated and surrounded by the ISF. Steady-state exchange of fluid and solute are considered by using conservation and exchange equations. We have used values for parameters based on experimental measurements and investigated the effects of the properties of the vasa recta, the flow, and the gradient of small solutes on the distribution of plasma proteins. Results from the model agree reasonably well with experimental measurements, suggesting that convection may account for the clearance of plasma proteins from the renal medulla maintaining their concentration below that of the AVR.