Changes in renal function in essential hypertension

Reubi, F; Weidmann, P; Hodler, J; Cottier, P

doi:10.1016/0002-9343(78)90573-9

Cited by 75 publications

(27 citation statements)

References 29 publications

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“…Perhaps the most consistent observations suggesting that renal vascular abnormalities are not a consequence but rather a cause of long-standing hypertension were made by Hollenberg et al 61 and Bianchi et al. 7(1 who observed that abnormalities in the renal circulation and its control were present in some normotensive subjects whose parents were hypertensive.…”

Section: Discussionmentioning

confidence: 81%

“…It should be concluded, therefore, that hypertension is not associated with a reduction in RBF in many hypertensive patients. 7 " Figure 5 shows that such an interpretation is questionable, since a significant reset existed in the relationship between CO and RBF in the hypertensive patients; for a given CO the RBF flow was lower. In particular, normal RBF was related to elevated values of CO.…”

Section: Discussionmentioning

confidence: 99%

“…1 " 7 The glomerular filtration rate (GFR) is reported to be normal or decreased proportionately less than RPF, which results in an increase in filtration fraction (FF).…”

mentioning

confidence: 99%

“…5 - 10 Others claim no correlation between arterial pressure and kidney hemodynamics. 7 -" Discrepancies Most investigations of renal hemodynamics have been cross-sectional studies. These studies require stable, homogeneous populations with precisely defined clinical and experimental conditions in order to compare two or more populations with respect to the function studied.…”

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confidence: 99%

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Renal and systemic hemodynamics in sustained essential hypertension.

London¹,

Me²,

Sassard³

et al. 1984

Hypertension

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SUMMARY Cardiac output (CO), renal blood flow (RBF), calf blood flow (CBF), and hepatic blood flow (HBF), glomerular filtration rate (GFR), and dopamine beta hydroxylase (D/3H) activity were studied in 198 men (67 normotensive controls and 131 hypertensive patients) of the same age with sustained uncomplicated essential hypertension. In the hypertensive men, the RBF and the RBF/CO ratio were significantly decreased (p < 0.001). The RBF and RBF/CO ratio were negatively correlated with age (p < 0.01), blood pressure (p < 0.01), and D/8H activity (p < 0.01). None of these relationships were observed with CBF and HBF. The observed decreases in RBF and the RBF/CO ratio in hypertensive men were reversed after administration of clonidine and alpha-methyldopa (p < 0.01), but not after administration of propranolol. The study provides evidence that the reduction of renal perfusion in essential hypertension is partly reversible and related to an abnormality in the adrenergic system control. (Hypertension 6: 743-754, 1984) KEY WORDS • renal perfusion • dopamine beta-hydroxylase • renal blood flow • renal plasma flow • glomerular filtration rate • cardiac output • adrenergic system

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

“…1 " 7 The glomerular filtration rate (GFR) is reported to be normal or decreased proportionately less than RPF, which results in an increase in filtration fraction (FF).…”

mentioning

confidence: 99%

mentioning

confidence: 99%

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Renal and systemic hemodynamics in sustained essential hypertension.

London¹,

Me²,

Sassard³

et al. 1984

Hypertension

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“…Renal plasma flows (RPF) (measured by p-aminohippurate clearance) decrease stepwise from 616 to 660 ml/min in normal subjects to 532 ml/min in borderline hypertensive subjects, to 475 to 505 ml/min in subjects with essential hypertension, to 317 ml/min in malignant hypertension (71,79). The level of GFR correlates with the changes in renal plasma flow (80) but does not show detectable decrease until the RPF falls to Ͻ450 to 475 ml/min (79). Interestingly, studies by Talbot et al in the 1940s showed that the changes in renal plasma flow and GFR also correlate with the severity of the renal arteriolar lesions (by biopsy) (42).…”

Section: Relevance Of Stages Of Hypertension With the Progression Of mentioning

confidence: 99%

Essential Hypertension, Progressive Renal Disease, and Uric Acid

Johnson

Segal

Srinivas

et al. 2005

Journal of the American Society of Nephrology

263

171

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Hypertension and hypertension-associated ESRD are epidemic in society. The mechanisms responsible for renal progression in mild to moderate hypertension and those groups most at risk need to be identified. Historic, epidemiologic, clinical, and experimental studies on the pathogenesis of hypertension and hypertension-associated renal disease are reviewed and an overview/hypothesis for the mechanisms involved in renal progression is presented. There is increasing evidence that hypertension may exist in one of two forms/stages. The first stage, most commonly observed in early or borderline hypertension, is characterized by salt-resistance, normal or only slightly decreased GFR, relatively normal or mild renal arteriolosclerosis, and normal renal autoregulation. This group is at minimal risk for renal progression. The second stage, characterized by salt-sensitivity, renal arteriolar disease, and blunted renal autoregulation, defines a group at highest risk for the development of microalbuminuria, albuminuria, and progressive renal disease. This second stage is more likely to be observed in blacks, in subjects with gout or hyperuricemia, with low level lead intoxication, or with severe obesity/metabolic syndrome. The two major mechanistic pathways for causing impaired autoregulation at mild to moderate elevations in BP appear to be hyperuricemia and/or low nephron number. Understanding the pathogenetic pathways mediating renal progression in hypertensive subjects should help identify those subjects at highest risk and may provide insights into new therapeutic maneuvers to slow or prevent progression.

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