Natriuresis-pressure relationship in polycystic kidney disease

Schmid, Marcel; Mann, Johannes F.E.; Stein, Günter; Herter, Marianne; Nussberger, J; Klingbeil, Arnfried U.; Ritz, Eberhard

doi:10.1097/00004872-199003000-00010

Cited by 45 publications

(25 citation statements)

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“…A similar difference was also found between normotensive ADPKD patients and unaffected family members [42]. In another study, hypertensive ADPKD patients had lower glomerular filtrate rate and higher baseline ANP levels, and showed an exaggerated response to sodium loading, much greater than that found in normotensive healthy subjects [43]. Thus, it seems that in ADPKD the increase in ANP levels is a phenomenon secondary to extracellular fluid expansion, but it is unknown if this peptide has any primary pathogenetic role.…”

Section: Atrial Natriuretic Peptidementioning

confidence: 54%

Left Ventricular Hypertrophy in Hypertensive Patients with Autosomal Dominant Polycystic Kidney Disease: Influence of Blood Pressure and Humoral and Neurohormonal Factors

Martínez-Vea¹,

Valero²,

Bardajı́³

et al. 2000

Am J Nephrol

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Left ventricular hypertrophy (LVH) is a common finding in hypertensive autosomal dominant polycystic kidney disease (ADPKD) patients. There are few studies on the influence of blood pressure (BP) and nonhemodynamic factors on LVH in these patients. The aim of this study was to evaluate the relationship between BP, humoral and neurohormonal factors and left ventricular mass (LVM) in hypertensive ADPKD patients. In 20 hypertensive ADPKD patients, ambulatory BP was monitored for 24 h, left ventricular dimensions were estimated by echocardiography, and plasma renin activity (PRA), plasma noradrenaline (NA), angiotensin II (Ang II), aldosterone, atrial natriuretic peptide (ANP) and insulin-like growth factor I (IGF-I) were also determined. Twenty age- and sex-matched essential hypertensive subjects served as controls. Ambulatory BP and LVM index were similar in the two groups, although male ADPKD patients had higher LVM indices than their matched controls. Eight ADPKD patients (40%) and 6 essential hypertensives (30%) showed LVH. PRA, Ang II, aldosterone, ANP and IGF-I levels were similar in the two groups, but plasma NA levels were higher in ADPKD patients than in controls (281 ± 158 vs. 160 ± 62 pg/ml, p = 0.004). ADPKD patients with LVH did not differ from those without LVH with regard to humoral and neurohormonal parameters, but had higher ambulatory BP levels. In ADPKD patients, correlation analysis revealed a significant association between LVM index and 24-hour systolic and diastolic BP, but not with any of the hormonal factors evaluated. On multiple regression analysis, 24-hour diastolic BP was the only independent variable linked to LVM index. In conclusion, ambulatory BP is one of the most important determinants of LVM in hypertensive ADPKD patients. Further studies are warranted to elucidate the role of nonhemodynamic factors in the pathogenesis of LVH in this population.

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Section: Atrial Natriuretic Peptidementioning

confidence: 54%

Left Ventricular Hypertrophy in Hypertensive Patients with Autosomal Dominant Polycystic Kidney Disease: Influence of Blood Pressure and Humoral and Neurohormonal Factors

Martínez-Vea¹,

Valero²,

Bardajı́³

et al. 2000

Am J Nephrol

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“…Therefore, Agt generated-AngII may contribute to excessive distal tubular salt reabsorption and increased blood pressure (FIGURE 1). This is also supported by the finding that the pressure-natriuresis curve in PKD patients with HTN is shifted toward the right, which may be explained if renal AngII is elevated from the activation of the intrarenal RAS (118,141). In humans, urinary Agt (U-Agt), a marker of intrarenal RAS activation, was examined in both ADPKD and healthy subjects.…”

Section: Hypertension In Pkdmentioning

confidence: 81%

Molecular Pathways and Therapies in Autosomal-Dominant Polycystic Kidney Disease

Saigusa

Bell

2015

Physiology

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Autosomal-dominant polycystic kidney disease (ADPKD) is the most prevalent inherited renal disease, characterized by multiple cysts that can eventually lead to kidney failure. Studies investigating the role of primary cilia and polycystins have significantly advanced our understanding of the pathogenesis of PKD. This review will present clinical and basic aspects of ADPKD, review current concepts of PKD pathogenesis, evaluate potential therapeutic targets, and highlight challenges for future clinical studies.

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“…Even at a normal GFR. blood pressure in ADPKD is clearly sodium sensitive, as demon strated by Schmid et al [15]. Mean arterial pressure in creased significantly in ADPKD.…”

Section: What Factors Contribute To Hypertension In Adpkd?mentioning

confidence: 81%

Genesis and Significance of Hypertension in Autosomal Dominant Polycystic Kidney Disease

Zeier

Ritz

Geberth

et al. 1994

Nephron

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Natriuresis-pressure relationship in polycystic kidney disease

Cited by 45 publications

References 0 publications

Left Ventricular Hypertrophy in Hypertensive Patients with Autosomal Dominant Polycystic Kidney Disease: Influence of Blood Pressure and Humoral and Neurohormonal Factors

Left Ventricular Hypertrophy in Hypertensive Patients with Autosomal Dominant Polycystic Kidney Disease: Influence of Blood Pressure and Humoral and Neurohormonal Factors

Molecular Pathways and Therapies in Autosomal-Dominant Polycystic Kidney Disease

Genesis and Significance of Hypertension in Autosomal Dominant Polycystic Kidney Disease

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