The renal functional reserve in recently diagnosed essential hypertension

Recent studies have shown that both in hypertensives and in offspring of hypertensive parents there exists an altered renal functional reserve (RFR). The aim of this research was to study the RFR in newly diagnosed essential hypertensives, and to evaluate if any influences are played on RFR by circulating renin-angiotensin-aldosterone system, catecholamines, and plasma endothelin-1. In 16 essential hypertensives (EH) and in 10 healthy controls (C), on the 24-hour urine collection and on urine specimens taken after both an oral water load and an amino acids (AAs) infusion (4.16 ml/min for two hours), Ccr, microalbuminuria (AER) and its fractional clearance, and sodium excretion (Nau) were evaluated. Furthermore, both in basal condition and after the AAs load, blood samples were obtained to assay plasma renin activity (PRA) and aldosterone concentrations (PAC), circulating norepinephrine (NE) and endothelin-1 (ET-1). The C-group showed a mean increase in Ccr of 35%. No significant modifications in AER and in circulating hormones were observed. Among the 16 EH, thirteen subjects showed a significant increase in Ccr after the AAs load, with a mean increase of 32.5%. In the whole group of EH there were no significant differences in AER when comparing basal with after-load values, and Nau resulted significantly decreased after AAs infusion. The analysis of the hormonal pattern pointed out not significant changes in the behaviour of PRA, NE and ET-1, while a significant decrease in PAC was observed.(ABSTRACT TRUNCATED AT 250 WORDS)