High altitude renal syndrome (HARS)

Area of Science:

• Physiology
• Altitude Medicine
• Nephrology

Background:

• Over 140 million people reside at high altitudes (>2400 m) facing chronic hypoxic conditions.
• Understanding genetic adaptations and environmental factors like cobalt exposure is crucial for high-altitude populations.

Purpose of the Study:

• To review the historical settlement of high-altitude regions.
• To examine genetic and environmental influences on physiological responses to hypoxia.
• To describe common renal physiological responses and clinical manifestations in high-altitude dwellers.

Main Methods:

• Historical review of high-altitude population studies.
• Analysis of genetic adaptations and environmental factors.
• Review of renal physiological responses and clinical presentations.

Main Results:

• Identified a novel clinical syndrome: high altitude renal syndrome (HARS).
• HARS is characterized by systemic hypertension, microalbuminuria, preserved GFR, polycythemia, and hyperuricemia.
• Angiotensin-converting enzyme (ACE) inhibitors show efficacy in reducing proteinuria and hemoglobin levels.

Conclusions:

• High altitude renal syndrome (HARS) represents a distinct clinical entity in high-altitude populations.
• ACE inhibitors may be a beneficial treatment for managing HARS symptoms, including proteinuria and polycythemia.