Treatment of hypertension in renal disease

D. S. Baldwin, Joel Neugarten

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Experimental and clinical evidence are summarized that support the hypothesis that enhanced transmission of systemic hypertension to the adapted glomerulus in the setting of reduced nephron mass may be responsible for accelerated vascular and glomerular damage in the hypertensive stage of parenchymal renal disease in man. In experimental models of hypertension associated with reduced renal mass, the kidney appears to be damaged directly by transmission of pressure rather than primarily through vasoconstriction and ischemia. When hypertension is combined with models of glomerular disease, vascular and glomerular injury are aggravated. It is proposed that adaptive glomerular hemodynamic alterations which occur in parenchymal renal disease magnify the transmission of increased pressure and flows when hypertension supervenes. Accelerated vascular and glomerular damage and functional deterioration result. According to this hypothesis, control of systemic hypertension and minimization of hydraulic stress on the diseased glomerulus become critical to the management of chronic renal disease and the prevention of progressive renal insufficiency.

Original languageEnglish (US)
JournalAmerican Journal of Kidney Diseases
Volume5
Issue number4
StatePublished - 1985
Externally publishedYes

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Renal Hypertension
Hypertension
Kidney
Blood Vessels
Therapeutics
Pressure
Vascular System Injuries
Nephrons
Vasoconstriction
Chronic Renal Insufficiency
Renal Insufficiency
Theoretical Models
Ischemia
Hemodynamics

ASJC Scopus subject areas

  • Nephrology

Cite this

Treatment of hypertension in renal disease. / Baldwin, D. S.; Neugarten, Joel.

In: American Journal of Kidney Diseases, Vol. 5, No. 4, 1985.

Research output: Contribution to journalArticle

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