Disturbances in renal autoregulation and the susceptibility to hypertension-induced chronic kidney disease.
The risk of developing chronic kidney disease in the setting of hypertension varies among patient populations. Black hypertensive patients have an increased risk of developing hypertension-induced chronic kidney disease even after taking into account socioeconomic factors. There is evidence to suggest that the kidney is intrinsically more susceptible to the damaging effects of hypertension in black patients. This susceptibility can be traced to disturbances in the way the kidney autoregulates. Impaired renal autoregulation may be the renal manifestation of a more widespread abnormality in endothelial function. Other conditions that can impair renal autoregulation and add to the risk of chronic kidney disease include low birth weight, obesity, insulin resistance, hyperuricemia, and hypercholesterolemia. To minimize the risk of chronic kidney disease in patients with impaired renal autoregulatory capability, strict blood pressure control is required. There is indirect evidence that blocking the renin-angiotensin system may improve renal autoregulation.
Palmer
Biff F
BF
Department of Internal Medicine, Division of Nephrology, University of Texas Southwestern Medical Center, Dallas, Texas 75390-8856, USA. biff.palmer@utsouthwestern.edu
D000375:Aging / Q000502:physiology; D000818:Animals; D003920:Diabetes Mellitus / Q000503:physiopathology; D004195:Disease Models, Animal; D004730:Endothelium, Vascular / Q000503:physiopathology; D005317:Fetal Growth Retardation / Q000503:physiopathology; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000503:physiopathology; D006973:Hypertension / Q000150:complications*; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007668:Kidney / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000503:physiopathology; D009765:Obesity / Q000150:complications / Q000503:physiopathology; D014527:Uric Acid / Q000097:blood
D014527:Uric Acid