Nephron Number, Hypertension, Renal Disease, and Renal Failure

摘要: Essential hypertension is one of the most common diseases in Western world, affecting about 26.4% adult population, and it increasing (1). Its causes are heterogeneous include genetic environmental factors (2), but several observations point to an important role kidney its genesis (3). In addition variations tubular transport mechanisms that could, for example, affect salt handling, structural characteristics might also contribute hypertension. The burden chronic disease worldwide, due population growth, longevity, changing risk factors. Although single-cause models still widely promoted, multideterminant or multihit can accommodate multiple individual a probably more applicable (4,5). such framework, nephron endowment potential determinant susceptibility. Some time ago, Brenner colleagues (6,7) proposed lower numbers predispose both essential renal disease. They progressive insufficiency be initiated accelerated by glomerular hypertrophy intraglomerular develops as number reduced (8). this review, we summarize data from recent studies shed light on these hypotheses. supply new twist possible Barker hypothesis, which proposes intrauterine growth retardation predisposes later life (9). review describes how estimated range some determinants morphologic correlates. It then considers low numbers. Finally, associations with considered, clinical implications discussed.