Electrolyte Blood Press.  2005 Mar;3(1):44-51.

Hypertension in Renal Diseases

• Joo KW

Abstract

Renal disease is closely associated with hypertension. Hypertension belongs to the clinical picture of chronic kidney disease (CKD). Hypertension associated with renal diseases occurs as a complication of various glomerular and interstitial diseases and may accelerate the decline of renal function if inadequately controlled. The pathophysiology through which the kidney raises blood pressure have been considerably clarified in recent years and it could be shown that "hypertension goes with the kidney" in experimental and clinical studies. The combined interactions of multiple independent mechanisms are thought to be involved in the development of hypertension. Impaired renal sodium handling leads to volume expansion. There is inappropriate activation of the renin-angiotensin system. As only recently documented in detail, renal injury raises the sympathetic tone, even when whole kidney glomerular filtration rate (GFR) is unchanged. This results from stimulating afferent signals coming from the kidney. There also is an evidence of impaired endothelial cell dependent vasodilatation even in very early stages of renal dysfunction. And other factors including uric acid, parathyoid hormone (PTH), and calcium may play a role in concert with other factors in the development of hypertension of renal diseases. Understanding these pathophysiologies is important for appropriate antihypertensive treatment.

MeSH Terms

Blood Pressure
Calcium
Endothelial Cells
Glomerular Filtration Rate
Hypertension*
Kidney
Kidney Failure, Chronic
Renal Insufficiency, Chronic
Renin-Angiotensin System
Sodium
Uric Acid
Vasodilation
Calcium
Sodium
Uric Acid