Renal function in hypertension.
Hypertension certainly accelerates the age-related changes in renal structure and function, mainly in the glomerulus. Both sodium handling and the renin-angiotensin system are involved in the aging process. Among the available classes of antihypertensive agents, the eventual deterioration of renal function induced by angiotensin-converting enzyme inhibitors in bilateral stenosis and stenosis of a single functioning kidney suggests that changes in glomerular pressure may participate in the changes of renal function. In essential hypertension and other conditions, it is possible that at a certain stage an increase in intraglomerular capillary pressure plays a role in the acceleration of the loss in renal function. As a consequence, it is proposed that in treating hypertension we should aim at reducing systemic blood pressure together with an attempt to reduce intraglomerular pressure using agents that act predominantly on post-glomerular resistance in order to have renal protection.
Mimran
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Policlinique, Hôpital Lapeyronie, Centre Hospitalier Universitaire, Montpellier, France.
D058186:Acute Kidney Injury / Q000139:chemically induced; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D007668:Kidney / Q000187:drug effects / Q000503:physiopathology*; D016030:Kidney Transplantation; D012078:Renal Artery Obstruction / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D012084:Renin-Angiotensin System / Q000187:drug effects; D012964:Sodium / Q000502:physiology
D000806:Angiotensin-Converting Enzyme Inhibitors; D012964:Sodium