Modern Drug Therapy

  • J. Webster
Part of the New Clinical Applications Nephrology book series (NCNG)


Renal hypertension is not easy to define. Many forms of acute and chronic renal parenchymal and vascular disease may be associated with hypertension. Causation is more difficult to prove. ‘Essential’ hypertension may affect at least 20% of the adult population in Western societies and as a result will frequently coexist with other diseases. Furthermore, sustained hypertension, of whatever cause, results in impaired renal function. In the strictest sense, causation may only be proved if the renal disorder can be shown to precede the development of hypertension, and if the hypertension resolves after removal of the offending kidney or resolution of the renal disorder. This is seldom possible. Hypertension may persist even after removal of the primary renal cause (for example, renal artery stenosis) as a result of irreversible damage in the contralateral kidney or structural changes in resistance vessels. Even in mild uncomplicated essential hypertension, there is evidence to suggest that the primary ‘lesion’ lies in the kidney1. There is clearly a wide spectrum of clinical conditions in which renal perfusion, renal function and systemic blood pressure are closely interrelated.


Renal Artery Hypertensive Patient Diabetic Nephropathy Angiotensin Converting Enzyme Renal Artery Stenosis 
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© MTP Press Limited 1988

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  • J. Webster

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