[A 100-year perspective on renal function and hypertension. Anti-renin therapy has made hypertensive renal failure a rarity].
One hundred years ago, in 1898, Professor Robert Tigerstedt, Karolinska institutet, Sweden, discovered renin. The subsequent elaboration in 1960 of the renin-angiotensin-aldosterone system signalled the start of modern hypertension research. The kidney takes part in blood pressure regulation in a number of ways. Indications are that increased renovascular resistance due to increased renin-angiotensin activity is of importance for the barostatic function of the kidneys and for the pathogenesis of human hypertension. Several commonly used, efficacious and well tolerated antihypertensive agents act by blocking the renin-angiotensin system, thus normalising kidney function. A number of current large-scale trials--utilising ACE inhibitors and angiotensin receptor antagonists--will, it is hoped, elucidate the proper role of 'anti-renin therapy' in the treatment of hypertension. Thanks to effective modern management of hypertension, renal failure due to hypertensive kidney disease is rare in Sweden today.
Bergström
G
G
Avdelningen för fysiologi, Göteborgs universitet.
Herlitz
H
H
Himmelmann
A
A
Ljungman
S
S
Aurell
M
M
D058186:Acute Kidney Injury / Q000503:physiopathology; D000804:Angiotensin II / Q000037:antagonists & inhibitors; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000266:history / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D006977:Hypertension, Renal / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000503:physiopathology; D012083:Renin / Q000266:history* / Q000502:physiology; D012084:Renin-Angiotensin System / Q000187:drug effects*; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D000804:Angiotensin II; D012083:Renin