Intraglomerular hypertension: implications and drug treatment

Systemic hypertension is both cause and consequence of progressive renal disease. Recent experimental studies indicate that systemic and glomerular capillary hypertension are not necessarily accompaniments, and that therapeutic interventions may affect systemic and glomerular pressures independently. Therapeutic interventions that control glomerular capillary hypertension protect against progressive renal injury, even in the presence of continued systemic hypertension. Conversely, therapy that controls systemic but not glomerular hypertension does not protect the kidney from continuing damage. Thus, control of intraglomerular hypertension is necessary if antihypertensive therapy is to be effective in preventing progression of renal injury.