Therapeutic benefit of converting-enzyme inhibition in progressive renal disease

Sharon Anderson, B. M. Brenner

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Systemic hypertension is both the cause and the consequence of renal disease. Experimental studies suggest that the adverse effects of systemic hypertension on the progression of renal disease may depend upon the intraglomerular hemodynamic consequences. Systemic hypertension accompanied by afferent arteriolar vasoconstriction is associated with normal glomerular capillary pressure and relative protection against morphologic injury. In contrast, systemic hypertension with afferent arteriolar vasodilatation leads to glomerular hypertension and is associated with structural injury. Glomerular hypertension may be present even in the setting of normal systemic pressure, as in experimental diabetes. Therapeutic interventions that attenuate glomerular capillary hypertension slow the development of glomerular injury. Dietary protein restriction, which normalizes glomerular capillary filtration, perfusion, and pressure without lowering blood pressure, retards the development of glomerular sclerosis. Alternatively, selective reduction of glomerular capillary pressure with converting-enzyme inhibitor therapy is also protective against progressive renal injury. In contrast, antihypertensive therapy, which controls systemic hypertension but does not reduce glomerular capillary pressure, fails to protect remnant kidney rats from glomerular injury. These studies suggest that control of glomerular hypertension may be of special benefit to the patient with progressive renal disease.

Original languageEnglish (US)
JournalAmerican Journal of Hypertension
Volume1
Issue number4 Part II
StatePublished - 1988
Externally publishedYes

Fingerprint

Hypertension
Kidney
Enzymes
Pressure
Wounds and Injuries
Therapeutics
Enzyme Therapy
Dietary Proteins
Sclerosis
Enzyme Inhibitors
Vasoconstriction
Vasodilation
Antihypertensive Agents
Disease Progression
Perfusion
Hemodynamics
Blood Pressure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Therapeutic benefit of converting-enzyme inhibition in progressive renal disease. / Anderson, Sharon; Brenner, B. M.

In: American Journal of Hypertension, Vol. 1, No. 4 Part II, 1988.

Research output: Contribution to journalArticle

@article{2f654a8461a1497e8bdbae3bff8fa4a5,
title = "Therapeutic benefit of converting-enzyme inhibition in progressive renal disease",
abstract = "Systemic hypertension is both the cause and the consequence of renal disease. Experimental studies suggest that the adverse effects of systemic hypertension on the progression of renal disease may depend upon the intraglomerular hemodynamic consequences. Systemic hypertension accompanied by afferent arteriolar vasoconstriction is associated with normal glomerular capillary pressure and relative protection against morphologic injury. In contrast, systemic hypertension with afferent arteriolar vasodilatation leads to glomerular hypertension and is associated with structural injury. Glomerular hypertension may be present even in the setting of normal systemic pressure, as in experimental diabetes. Therapeutic interventions that attenuate glomerular capillary hypertension slow the development of glomerular injury. Dietary protein restriction, which normalizes glomerular capillary filtration, perfusion, and pressure without lowering blood pressure, retards the development of glomerular sclerosis. Alternatively, selective reduction of glomerular capillary pressure with converting-enzyme inhibitor therapy is also protective against progressive renal injury. In contrast, antihypertensive therapy, which controls systemic hypertension but does not reduce glomerular capillary pressure, fails to protect remnant kidney rats from glomerular injury. These studies suggest that control of glomerular hypertension may be of special benefit to the patient with progressive renal disease.",
author = "Sharon Anderson and Brenner, {B. M.}",
year = "1988",
language = "English (US)",
volume = "1",
journal = "American Journal of Hypertension",
issn = "0895-7061",
publisher = "Oxford University Press",
number = "4 Part II",

}

TY - JOUR

T1 - Therapeutic benefit of converting-enzyme inhibition in progressive renal disease

AU - Anderson, Sharon

AU - Brenner, B. M.

PY - 1988

Y1 - 1988

N2 - Systemic hypertension is both the cause and the consequence of renal disease. Experimental studies suggest that the adverse effects of systemic hypertension on the progression of renal disease may depend upon the intraglomerular hemodynamic consequences. Systemic hypertension accompanied by afferent arteriolar vasoconstriction is associated with normal glomerular capillary pressure and relative protection against morphologic injury. In contrast, systemic hypertension with afferent arteriolar vasodilatation leads to glomerular hypertension and is associated with structural injury. Glomerular hypertension may be present even in the setting of normal systemic pressure, as in experimental diabetes. Therapeutic interventions that attenuate glomerular capillary hypertension slow the development of glomerular injury. Dietary protein restriction, which normalizes glomerular capillary filtration, perfusion, and pressure without lowering blood pressure, retards the development of glomerular sclerosis. Alternatively, selective reduction of glomerular capillary pressure with converting-enzyme inhibitor therapy is also protective against progressive renal injury. In contrast, antihypertensive therapy, which controls systemic hypertension but does not reduce glomerular capillary pressure, fails to protect remnant kidney rats from glomerular injury. These studies suggest that control of glomerular hypertension may be of special benefit to the patient with progressive renal disease.

AB - Systemic hypertension is both the cause and the consequence of renal disease. Experimental studies suggest that the adverse effects of systemic hypertension on the progression of renal disease may depend upon the intraglomerular hemodynamic consequences. Systemic hypertension accompanied by afferent arteriolar vasoconstriction is associated with normal glomerular capillary pressure and relative protection against morphologic injury. In contrast, systemic hypertension with afferent arteriolar vasodilatation leads to glomerular hypertension and is associated with structural injury. Glomerular hypertension may be present even in the setting of normal systemic pressure, as in experimental diabetes. Therapeutic interventions that attenuate glomerular capillary hypertension slow the development of glomerular injury. Dietary protein restriction, which normalizes glomerular capillary filtration, perfusion, and pressure without lowering blood pressure, retards the development of glomerular sclerosis. Alternatively, selective reduction of glomerular capillary pressure with converting-enzyme inhibitor therapy is also protective against progressive renal injury. In contrast, antihypertensive therapy, which controls systemic hypertension but does not reduce glomerular capillary pressure, fails to protect remnant kidney rats from glomerular injury. These studies suggest that control of glomerular hypertension may be of special benefit to the patient with progressive renal disease.

UR - http://www.scopus.com/inward/record.url?scp=0023739263&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0023739263&partnerID=8YFLogxK

M3 - Article

VL - 1

JO - American Journal of Hypertension

JF - American Journal of Hypertension

SN - 0895-7061

IS - 4 Part II

ER -