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Hypertension and the kidney

J A Whitworth1, M A Brown

  • 1Department of Medicine, University of New South Wales, Australia.

Kidney International. Supplement
|July 1, 1993
PubMed
Summary

Research explores hypertension, focusing on vascular lesions and renal parenchymal disease. Studies suggest impaired cortisol-cortisone shuttle and 11-beta-HSD activity contribute to steroid-induced hypertension.

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Area of Science:

  • Nephrology
  • Endocrinology
  • Cardiovascular Research

Background:

  • Priscilla Kincaid-Smith's work on hypertension pathogenesis, particularly vascular lesions.
  • Investigating the role of the cortisol-cortisone shuttle and 11-beta-hydroxy-steroid dehydrogenase in renal parenchymal disease hypertension.
  • Defining renal functional consequences of steroid-induced hypertension.

Discussion:

  • Glucocorticoid-induced hypertension is independent of volume/sodium status but modulated by dietary sodium.
  • Normal pregnancy involves adaptation to sodium extremes, unlike pre-eclampsia.
  • Pre-eclampsia is characterized by sodium retention and enhanced capillary permeability.

Key Insights:

  • Impaired cortisol-cortisone shuttle and reduced 11-beta-HSD activity in renal hypertension.
  • Steroid-induced hypertension mechanisms elucidated, independent of volume shifts.
  • Pre-eclampsia pathophysiology involves abnormal aldosterone:renin ratio, dopaminergic pathways, natriuretic peptides, and prostacyclin:thromboxane balance.

Outlook:

  • Further research into the cortisol-cortisone shuttle's role in hypertension.
  • Exploring therapeutic targets for steroid-induced and pre-eclampsia-related hypertension.
  • Investigating the interplay of hormonal and vascular factors in hypertensive disorders.

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