Hypertension and the kidney: lessons learned from transplantation.
This review discusses the analogies between some experimental models of arterial hypertension and some probable causes of hypertension in kidney-transplanted patients. Some subgroups of these patients have striking similarities with some animal models: Data suggest that the genetic predisposition to hypertension can be transmitted with the kidney, similar to the transplantation experiments in genetically hypertensive rat stains. Patients with graft artery stenosis, if previously binephrectomized, present the same puzzling sequence of events in the development of hypertension as the one-kidney one-clip Golblatt hypertension animal models. "Native kidney" hypertension can be related to a state of chronic angiotensin excess as in the chronically angiotensin-infused animals. Confounding variables include chronic steroid therapy, chronic rejection, and the possible role of renal nerve regeneration. There are also animal models available for these contributing factors that allow us to understand the many facets of post transplant hypertension better.
Guidi
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Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
D000804:Angiotensin II / Q000378:metabolism; D000818:Animals; D004195:Disease Models, Animal; D006083:Graft Occlusion, Vascular / Q000209:etiology; D006084:Graft Rejection; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D006978:Hypertension, Renovascular / Q000209:etiology; D007668:Kidney / Q000294:innervation; D016030:Kidney Transplantation; D011183:Postoperative Complications; D051381:Rats; D013256:Steroids / Q000009:adverse effects
D013256:Steroids; D000804:Angiotensin II