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[Nephropathies and arterial hypertension]
1Service de Néphrologie et d'Hypertension artérielle, Centre Hospitalier, Vanes.
Abstract:
HIGH PREVALENCE: Hypertension is observed in 85% of patients with end-stage renal disease. Its prevalence is also very high in renal transplant recipients.
Possible Mechanisms:
High blood pressure in primary renal disease may be related to water-electrolyte overload resulting from reduced sodium excretion (volume- or sodium-dependent mechanism). It could also result from renin-dependent mechanisms as in patients with unilateral disease or polycystic kidneys.
Prognosis:
High blood pressure is a factor predicting poor prognosis in renal disease. It has been demonstrated that controlling hypertension has a beneficial effect on the course of renal failure.
Other Factors:
Hyperfiltration and high glomerular capillary pressure also play a role in the progression of chronic renal disease. The polymorphism of the angiotensin converting enzyme gene is also involved. In the diabetic patient as well as in patients with renal disease other than diabetes, a large amount of work has shown that converting enzyme inhibitors have more effect on showing the progression of renal failure than do other antihypertensive drugs.