Kidney and hypertension

摘要: Kidney and hypertension. There is a unique relationship between the kidney blood pressure (BP): on one hand, renal dysfunction particularly disease cause an increase in BP, while other high BP accelerates loss of function diseased kidney. Transplantation studies, both experimental animals humans, documented that "blood goes with kidney," normotensive recipient genetically programmed for hypertension (HT) will develop HT, conversely hypertensive patients failure receiving donor may normotension. Family studies showed higher values more frequent HT first degree relatives primary glomerulonephritis or diabetic nephropathy, type 1 2. The notion has been proposed at turn century, but definite evidence by observational interventional only provided last two decades. issue much confounded mistaken believe damaged kidneys require order to properly. mechanisms comprise: salt retention, inappropriate activity renin-angiotensin system (RAS) sympathetic nerve as well impaired endothelial cell-mediated vasodilatation. ample (AIPRI REIN trials) nephropathy 2 diabetes (IDNT, RENAAL) pharmacological blockade RAS angiotensin-converting enzyme inhibitors angiotensin II receptor blockers BP-independent renoprotective effects. More recently, it also shown effects albuminuria glomerulosclerosis.