Glomeruli and blood pressure. Less of one, more the other?

B. M. Brenner, D. L. Garcia, Sharon Anderson

Research output: Contribution to journalArticle

935 Citations (Scopus)

Abstract

A primary role of the kidney in the initiation and maintenance of hypertension has long been recognized, but the pathogenetic interactions among renal hemodynamics, hormonal and hereditary factors, and dietary sodium intake remain enigmatic. Reduction in filtration surface area, whether acquired in the course of intrinsic renal disease or after surgical renal ablation, leads to systemic hypertension as well as to progressive renal insufficiency, sequelae made even more severe by dietary sodium excess. Moreover, hypertension and progressive renal disease eventuate in some individuals born with a solitary kidney, as well as in those with more severe degrees of dysgenesis (ie, oligomeganephronia). Hypertension is also commonly observed in certain inbred rat strains in which filtration surface area is congenitally deficient. Based on these and other lines of evidence reviewed herein, we postulate that a renal abnormality that contributes to essential hypertension in the general population is a reduced number of nephrons. The consequences of this abnormality are limitations in the ability to excrete sodium and thus, salt-sensitive hypertension. Finally, congenital variability in filtration surface area may explain why only some, but not all, patients exposed to potentially injurious renal stimuli eventually manifest chronic nephropathy. This may also account for the susceptibility of subsets of Type I and Type Ii diabetics to develop overt glomerulopathy.

Original languageEnglish (US)
Pages (from-to)335-347
Number of pages13
JournalAmerican Journal of Hypertension
Volume1
Issue number4 Part I
StatePublished - 1988
Externally publishedYes

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Blood Pressure
Kidney
Hypertension
Dietary Sodium
Inbred Strains Rats
Renal Hypertension
Nephrons
Renal Insufficiency
Salts
Hemodynamics
Sodium
Maintenance
Population

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Glomeruli and blood pressure. Less of one, more the other? / Brenner, B. M.; Garcia, D. L.; Anderson, Sharon.

In: American Journal of Hypertension, Vol. 1, No. 4 Part I, 1988, p. 335-347.

Research output: Contribution to journalArticle

Brenner, BM, Garcia, DL & Anderson, S 1988, 'Glomeruli and blood pressure. Less of one, more the other?', American Journal of Hypertension, vol. 1, no. 4 Part I, pp. 335-347.
Brenner, B. M. ; Garcia, D. L. ; Anderson, Sharon. / Glomeruli and blood pressure. Less of one, more the other?. In: American Journal of Hypertension. 1988 ; Vol. 1, No. 4 Part I. pp. 335-347.
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