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Renal surrogates in essential hypertension
1Hypertension Unit, Hospital 12 de Octubre, Madrid, Spain.
Insights
The kidney plays a dual role in hypertension, contributing to its development and suffering damage. Early signs include renal vasoconstriction and altered kidney function markers, potentially leading to nephrosclerosis.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Hypertension Research
Background:
- The kidney is implicated as both a cause and a victim in the hypertensive process.
- Renal functional derangements contribute significantly to the development and progression of arterial hypertension.
- Vascular damage within the kidney, at glomerular and arteriolar levels, leads to progressive nephrosclerosis.
Purpose of the Study:
- To elucidate the kidney's role in the hypertensive process.
- To detail the early and progressive functional alterations in the kidney associated with hypertension.
- To highlight key biomarkers indicative of renal involvement in hypertension.
Main Methods:
- Observational analysis of renal function in hypertensive individuals.
- Assessment of common early-stage alterations in essential hypertension.
- Monitoring of urinary biomarkers and glomerular filtration rate.
Main Results:
- Renal vasoconstriction is a common early finding in essential hypertension.
- Associated markers include hyperuricemia and increased urinary excretion of N-acetyl-beta-glucosaminidase.
- Persistent hypertension can lead to a decline in glomerular filtration rate and potential proteinuria.
Conclusions:
- The kidney is central to the pathophysiology of hypertension.
- Early detection of renal functional changes and biomarkers is crucial.
- Progressive nephrosclerosis results from sustained hypertensive damage to renal vasculature.
Abstract:
The kidney can be considered both as culprit and victim in the hypertensive process. Renal functional derangement contributes to the development of arterial hypertension and the development of secondary vascular damage both at the glomerular and arteriolar level accounts for the development of progressive nephrosclerosis. The most common alteration of renal function observed in humans since the early stages of essential hypertension is the presence of renal vasoconstriction. This can be accompanied by the appearance of hyperuricemia, increased urinary excretion of enzymes such as N-acetyl-beta- glucosaminidase and of proteins like albumin and beta2-microglobulin. Later on, a progressive fall in glomerular filtration rate accompanied or not by proteinuria can be observed if high blood pressure persists.