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The Kidney and Regulation of Blood Pressure

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Renovascular and Renal Parenchymatous Hypertension

Abstract

Evidence that the kidneys play a key role in blood pressure regulation comes from the fact that chronic abnormalities of blood pressure control, such as hypertension, almost always begin with some abnormality of renal function. For example, Goldblatt hypertension begins with stenosis of one or both of the renal arteries; mineralocorticoid hypertension begins with increased renal tubular sodium reabsorption; and hypertension caused by infusion of vasoconstrictors such as angiotensin III (AII) or norepinephrine may be associated with increased tubular reabsorption as well as renal vasoconstriction. As hypertension develops, many of these initial changes in renal function are obscured by various compensatory mechanisms that act to restore renal excretory function toward normal. Secondary to increased arterial pressure, a cascade of circulatory alterations occurs that in many instances is much more striking than the disturbance of renal function, even though the original abnormality was in the kidney. For this reason, the importance of changes in renal function in causing hypertension has often been underestimated.

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Authors
  1. J. E. Hall
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  2. A. C. Guyton
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Editors and Affiliations

  1. Departement Innere Medizin, Kantonsspital Basel Petersgraben 4, CH-4031, Basel, Switzerland

    Thomas F. Lüscher

  2. University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, 75 235-8899, Dallas, TX, USA

    Norman Meyer Kaplan

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© 1992 Springer Verlag, Berlin Heidelberg

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Hall, J.E., Guyton, A.C. (1992). The Kidney and Regulation of Blood Pressure. In: Lüscher, T.F., Kaplan, N.M. (eds) Renovascular and Renal Parenchymatous Hypertension. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-61239-8_1

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  • DOI: https://doi.org/10.1007/978-3-642-61239-8_1

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-64756-7

  • Online ISBN: 978-3-642-61239-8

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