Asymmetry of Renal Blood Flow in Patients With Moderate to Severe Hypertension

Onna, Marieke van; Houben, A. J. H. M.; Kroon, Abraham A.; Wierema, Thomas K.A.; Koster, Derk; Engelshoven, Jos M. A. van; Leeuw, Peter W. de

doi:10.1161/01.hyp.0000050928.96979.a5

Cited by 30 publications

(17 citation statements)

References 24 publications

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“…Van Onna and co-authors showed that asymmetry of renal blood flow was present in up to 51% of hypertensive patients. Moreover, mean left renal blood flow was on average significantly lower than the right mean renal blood flow (van Onna et al, 2002). Similar, Caralps et al reported that in 10 out of 11 asymmetry cases the left kidney was more affected than the right one (Caralps et al, 1974).…”

Section: Discussionmentioning

confidence: 95%

Ectopic Adipose Tissue Storage in the Left and the Right Renal Sinus is Asymmetric and Associated With Serum Kidney Injury Molecule-1 and Fibroblast Growth Factor-21 Levels Increase

et al. 2016

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ObjectiveA potential mechanism by which obesity could promote hypertension and kidney diseases is through accumulation of adipose tissue in the renal sinus (RS). The aim of the study was to quantify RS and abdominal adipose tissue volumes and to evaluate serum kidney injury molecule (sKIM)-1 and fibroblast growth factor (FGF)-21 association with different adipose tissue compartments.MethodsThe cross-sectional study included 280 and follow-up study-40 asymptomatic participants; aged 38.30 ± 4.10. For all study participants computed tomography examination was performed, sKIM-1 and FGF-21 levels were measured.ResultsThe results indicated asymmetrical deposition of adipose tissue into the RS even after corresponding kidney volume adjustment. The cross-sectional and the follow-up studies showed that sKIM-1 level was positively associated with RS adipose tissue volume increase for both genders. FGF-21 was positively associated with RS and retroperitoneal adipose tissue amount.ConclusionsRegardless of gender adipose tissue in RS accumulates asymmetrically–the left RS accumulates a significantly higher amount of adipose tissue. Thus, primarily RS adipose tissue effects should be assessed on the left kidney. Accumulation of adipose tissue in the RS is related with the visceral adipose amount, KIM-1 and FGF-21 concentration increase in the blood serum.

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Section: Discussionmentioning

confidence: 95%

Ectopic Adipose Tissue Storage in the Left and the Right Renal Sinus is Asymmetric and Associated With Serum Kidney Injury Molecule-1 and Fibroblast Growth Factor-21 Levels Increase

et al. 2016

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“…only discernable by an asymmetry in left to right RBF, already affects renal regulation of blood pressure [77]. The other aspect involves both the stenotic and the contralateral kidney: enhanced actions of ANG II will lead to sodium retention directly and indirectly due to aldosterone formation, with increased extracellular fluid volume as a consequence.…”

Section: Special Case: Renal Artery Stenosismentioning

confidence: 99%

Systemic arterial and venous determinants of renal hemodynamics in congestive heart failure

Braam

Cupples

Joles³

et al. 2011

Heart Fail Rev

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Heart and kidney interactions are fascinating, in the sense that failure of the one organ strongly affects the function of the other. In this review paper, we analyze how principal driving forces for glomerular filtration and renal blood flow are changed in heart failure. Moreover, renal autoregulation and modulation of neurohumoral factors, which can both have repercussions on renal function, are analyzed. Two paradigms seem to apply. One is that the renin-angiotensin system (RAS), the sympathetic nervous system (SNS), and extracellular volume control are the three main determinants of renal function in heart failure. The other is that the classical paradigm to analyze renal dysfunction that is widely applied in nephrology also applies to the pathophysiology of heart failure: pre-renal, intra-renal, and post-renal alterations together determine glomerular filtration. At variance with the classical paradigm is that the most important post-renal factor in heart failure seems renal venous hypertension that, by increasing renal tubular pressure, decreases GFR. When different pharmacological strategies to inhibit the RAS and SNS and to assist renal volume control are considered, there is a painful lack in knowledge about how widely applied drugs affect primary driving forces for ultrafiltration, renal autoregulation, and neurohumoral control. We call for more clinical physiological studies.

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“…Yet, it might have important consequence for the development of cardiovascular disease, because van Onna et al reported an asymmetry of renal blood flow in patients with moderate to severe hypertension. 23 Sympathetic hyperinnervation and vascular smooth muscle hyperplasia may be involved in the development of hypertension in experimental animals 24,25 and possibly humans. 26 Previous studies from our own group in the chicken embryo demonstrated that chronic moderate hypoxia results in a sympathetic hyperinnervation of the arterial system.…”

Section: Sanders Et Al Intrauterine Stress and Renal Development 1287mentioning

confidence: 99%

Reduced Uteroplacental Blood Flow Alters Renal Arterial Reactivity and Glomerular Properties in the Rat Offspring

et al. 2004

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Abstract-Fetal malnutrition and hypoxia may modify organ system maturation and result in cardiovascular diseases in the adult. We tested whether intrauterine stress (IUS) leads to persistent alterations of renal biology. In rats, intrauterine stress was induced by ligation of the uterine arteries at day 17 of pregnancy. Renal arteries of the 21-day-old male offspring were isolated to study pharmacological reactivity. Kidneys were dissected to analyze renal structure and ␤-adrenoceptor expression. At 21 days of age, half of the animals underwent unilateral left nephrectomy. At the age of 12 weeks, rats were instrumented for blood pressure monitoring, blood sampling, and renal function measurements. After IUS, litter size and birth weight were reduced, whereas the hematocrit was increased. Renal arterial responses to ␤-adrenergic stimulation and sensitivity to adenylyl cyclase activation were increased, along with the renal expression of ␤ 2 -adrenoceptors. At 21 days and at 6 months of age, the number and density of the glomeruli were reduced, whereas their size was increased. The filtration fraction and urinary albumin concentration were increased 12 weeks after intrauterine stress. In control rats, removal of the left kidney at 21 days of age did not affect kidney function and blood pressure. However, after IUS, the remaining right kidney failed to compensate for the loss of the left kidney, and blood pressure was increased. In conclusion, prenatal stress transiently modifies renal arterial reactivity and results in long-lasting adverse effects on renal structure and function and on renal compensatory mechanisms. Key Words: hypertension Ⅲ kidney Ⅲ glomerular filtration rate Ⅲ nephrectomy Ⅲ pregnancy Ⅲ rats Ⅲ renal artery Ⅲ receptors, adrenergic beta C ardiovascular, endocrine and metabolic diseases can emerge as a consequence of intrauterine stress (IUS). 1 A suboptimal fetal environment is often the result of placental insufficiency, which leads to an inadequate delivery of nutrients and oxygen to the fetus. Many animal models have been established that support a link between prenatal conditions and the development of disease in the adult. These include maternal caloric and protein restriction, 2 exposure to hypoxia, 3 and ligation of the uterine arteries to mimic placental insufficiency. 4 Hypoxia and malnutrition during fetal life were reported to affect the renin-angiotensin system, the hypothalamicpituitary-adrenal axis, 5 vascular endothelial function and sympathetic innervation, 3,4,6 and the development of organs like the kidney. 7 The number of glomeruli can be permanently reduced by influences during fetal life. These structural changes may contribute to renal dysfunction 8 and hypertension 9 later in life. Other aspects of renal organogenesis, such as renal vascular development and particularly adrenoceptor-mediated renovascular responses, 10 might also be influenced by disturbed fetal growth. In the rat, an unfavorable intrauterine environment, induced by uterine artery ligation, modified postnatal ...

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Asymmetry of Renal Blood Flow in Patients With Moderate to Severe Hypertension

Cited by 30 publications

References 24 publications

Ectopic Adipose Tissue Storage in the Left and the Right Renal Sinus is Asymmetric and Associated With Serum Kidney Injury Molecule-1 and Fibroblast Growth Factor-21 Levels Increase

Ectopic Adipose Tissue Storage in the Left and the Right Renal Sinus is Asymmetric and Associated With Serum Kidney Injury Molecule-1 and Fibroblast Growth Factor-21 Levels Increase

Systemic arterial and venous determinants of renal hemodynamics in congestive heart failure

Reduced Uteroplacental Blood Flow Alters Renal Arterial Reactivity and Glomerular Properties in the Rat Offspring

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