Hypertension and the kidney.
From our perspective, Priscilla Kincaid-Smith's major achievement in the field of hypertension relates to the pathogenesis of vascular lesions. Our own studies of the hypertension of renal parenchymal disease have suggested a role for impairment of the cortisol-cortisone shuttle and decreased activity of the enzyme complex 11-beta-hydroxy-steroid dehydrogenase. We have defined the renal functional consequences of steroid-induced hypertension and shown that the rise in blood pressure produced by steroids with predominant glucocorticoid activity is not dependent on volume shifts or sodium status, although the magnitude of the rise is modulated by dietary sodium content. We have shown that normal pregnant women adapt readily to extremes of sodium intake while women with pre-eclampsia retain sodium, and have shown enhanced capillary permeability. Recent studies have defined an abnormal aldosterone:renin ratio, dopaminergic inhibition of aldosterone, elevations of plasma atrial natriuretic peptide and reduced urinary prostacyclin:thromboxane ratios in women with pre-eclampsia.
Whitworth
J A
JA
Department of Medicine, University of New South Wales, Australia.
Brown
M A
MA
D000305:Adrenal Cortex Hormones / Q000502:physiology; D009320:Atrial Natriuretic Factor / Q000502:physiology; D001315:Australia; D005260:Female; D049673:History, 20th Century; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000266:history*; D006977:Hypertension, Renal / Q000209:etiology / Q000266:history; D007668:Kidney / Q000503:physiopathology*; D009398:Nephrology / Q000266:history; D011225:Pre-Eclampsia / Q000503:physiopathology; D011247:Pregnancy; D012084:Renin-Angiotensin System / Q000502:physiology
D000305:Adrenal Cortex Hormones; D009320:Atrial Natriuretic Factor