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Hypertension and the kidney

A E Raine1

  • 1Department of Nephrology, St Bartholomew's Hospital, London, UK.

British Medical Bulletin
|April 1, 1994
PubMed
Summary

The kidney plays a key role in essential hypertension, with subtle renal function abnormalities seen in offspring of hypertensive parents. Hypertension can cause kidney failure, especially in Black individuals, though treatment can slow function loss.

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Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Hypertension Research

Background:

  • The kidney's role in blood pressure regulation is critical, involving rapid adjustments in renal hemodynamics and sodium excretion.
  • Established hypertension resets normal renal functions, but subtle abnormalities in normotensive offspring suggest a potential central role of the kidney in essential hypertension pathogenesis.
  • Cross-transplantation studies in animal models support the hypothesis of the kidney's central role in hypertension development.

Purpose of the Study:

  • To explore the intricate relationship between hypertension and kidney function.
  • To investigate the kidney's potential role in the pathogenesis of essential hypertension.
  • To examine the impact of hypertension on renal function and the effectiveness of treatments.

Main Methods:

  • Review of existing literature on renal function in hypertension.
  • Analysis of studies on normotensive offspring of hypertensive parents.
  • Examination of cross-transplantation studies in animal models.
  • Evaluation of data on hypertensive nephropathy and racial differences.
  • Assessment of the effects of hypertension treatment in renal disease.

Main Results:

  • Subtle renal function abnormalities are present in normotensive offspring of hypertensive parents, indicating a possible kidney role in essential hypertension.
  • Hypertension can lead to severe renal failure, particularly in its malignant phase.
  • Hypertensive nephropathy is significantly more common in Black individuals compared to White individuals, a difference whose reasons are unknown.
  • Secondary hypertension frequently co-exists with renal disease, accelerating renal function decline.
  • Effective antihypertensive treatment, especially with converting enzyme inhibitors, can slow renal function loss in both animal models and human diseases like diabetic nephropathy.

Conclusions:

  • The kidney is intricately linked to hypertension, potentially playing a central role in its development.
  • Hypertension poses a significant threat to kidney health, with notable racial disparities in susceptibility to hypertensive renal injury.
  • Managing hypertension is crucial for preserving renal function, with specific treatments showing promise in slowing disease progression.

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