Changes in renal function associated with drug or placebo therapy of human hypertension

Magee, Joseph H.; Unger, Allan M.; Richardson, David W.

doi:10.1016/0002-9343(64)90187-1

Cited by 30 publications

(7 citation statements)

References 15 publications

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“…There is a decrease in GFR (now manifested by a rise in the serum creatinine and/or a fall in the creatinine clearance), which is proportionally less than the decrease in ERPF/RBF, sustaining the rise in the filtration frac- tion [1-5, 8-12, 14]. Overt proteinurla may be observed [22,43,44]. Hypertensive nephrosclerosis is pathologically present.…”

Section: Pathophysiology Of the Essential Hypertensive Kidneymentioning

confidence: 99%

“…However, there are no prospective studies that have systemically examined the relationship between hypertension and the status of renal function in patients with essential hypertension. It is equally clear that renal function may deteriorate during traditional (i.e., stepped-care) antihypertensive therapy [22,43,44,[50][51][52][53][54]. Currently, hypertensive nephrosclerosis accounts for approximately 15-25% of all end-stage renal disease in the United States [55,56].…”

Section: Pathophysiology Of the Essential Hypertensive Kidneymentioning

confidence: 99%

“…Specifically, there is a progressive rise in renal vascular resistance (RVR) and a progressive fall in effective renal plasma flow (ERPF)/renal blood flow (RBF) [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. The glomerular filtration rate (GFR) is relatively maintained [1][2][3][4][5][6][7][8][9][10][11][12][13], although serious renal impairment may occur in up to 20% of essential hypertensive patients [15][16][17][18][19][20][21][22] (Figure 1, phases I-V). The initial changes are functional and reversible, presumably mediated by neurohumoral mechanisms, including enhanced renal vascular response to circulating or endogenous norepinephrine and angiotensin II [23][24][25][26][27][28][29][30][31].…”

mentioning

confidence: 99%

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Acute and chronic effects of angiotensin converting enzyme inhibitors on the essential hypertensive kidney

Reams

Bauer

1990

Cardiovasc Drug Ther

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The natural course of essential hypertensive renal disease is characterized by a slowly progressive impairment of renal function. Initially, the changes are functional and reversible; however, structural changes gradually occur, leading to hypertensive nephrosclerosis. Similarities exist between the early functional hemodynamic changes observed in the essential hypertensive kidney and the physiologic renal effects of angiotensin II. To the degree that the initial functional changes are the result of excessive endogenous production of angiotensin II, interruption of the integrity of this humoral system could be expected to reverse the pathophysiologic sequence of events leading to hypertensive nephrosclerosis. This review focuses on the pathophysiology of the essential hypertensive kidney, the intrarenal effects of angiotensin II, and the acute and chronic effects of angiotensin converting enzyme (ACE) inhibition therapy on the essential hypertensive kidney. The data reviewed suggest that ACE inhibition therapy does reverse the initial functional hemodynamic changes observed in the essential hypertensive kidney and may protect the glomerulus from hemodynamically mediated injury.

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Section: Pathophysiology Of the Essential Hypertensive Kidneymentioning

confidence: 99%

Section: Pathophysiology Of the Essential Hypertensive Kidneymentioning

confidence: 99%

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confidence: 99%

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Acute and chronic effects of angiotensin converting enzyme inhibitors on the essential hypertensive kidney

Reams

Bauer

1990

Cardiovasc Drug Ther

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“…This study involved mostly white men and because of the nature of the data retrieval probably underestimates the problem. Earlier studies by Moyer et al 5 and Magee and coworkers 18 also clearly documented that untreated hypertension commonly results in ESRD.…”

Section: Risk Factors For Chronic Renal Failure Hypertensionmentioning

confidence: 88%

End-stage Renal Disease in Specific Ethnic and Racial Groups

Jd²

1998

Arch Intern Med

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During the past few years, it has become apparent that there are factors that place a person at greater risk for the development and progression of renal failure. This has been documented since the early 1980s by the United States Renal Data System that has collected data confirming that end-stage renal disease occurs at a greater rate in certain subpopulations of Americans. It is evident from an examination of the data that African Americans and American Indians have an incidence of end-stage renal disease that is not proportional to their percentage of the total population. In fact, African Americans and American Indians are reported to have at least a 4-fold greater incidence of end-stage renal disease than white Americans. There have been 5 factors identified: hypertension, glucose intolerance, insulin resistance, salt sensitivity, and hyperlipidemia, which may play a greater role in these subpopulations. In addition, as with other populations, lifestyle issues may serve to alter these primary risk factors or may act as direct modulators of renal disease progression. There is also a possibility that interactions between risk factors frequently occur that may modify the development or progression of the disease. This article reviews these risk factors and emphasizes the interaction between hypertension and the other factors. In addition, the effects of antihypertensive agents on risk factors and on renal outcome are emphasized. Where possible, issues specific to African Americans and American Indians are underscored; however, one must accept that the database on these populations is only now developing. This review should help the clinician make appropriate choices when prescribing antihypertensive therapy for patients who may be at risk of developing progressive renal failure.

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“…Several observational studies [23][24][25] and multiple small studies [26][27][28][29] showed the benefit of lower BP targets with respect to kidney and CV outcomes. However, given their observational design, small size, and surrogate endpoints, they did not have the ability to conclusively provide evidence for a lower BP goal.…”

Section: Optimal Bp Targetsmentioning

confidence: 99%

Optimizing Blood Pressure Control in Patients With Nondiabetic Glomerular Disease

Umanath

Lewis

Dwyer

2014

Advances in Chronic Kidney Disease

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Changes in renal function associated with drug or placebo therapy of human hypertension

Cited by 30 publications

References 15 publications

Acute and chronic effects of angiotensin converting enzyme inhibitors on the essential hypertensive kidney

Acute and chronic effects of angiotensin converting enzyme inhibitors on the essential hypertensive kidney

End-stage Renal Disease in Specific Ethnic and Racial Groups

Optimizing Blood Pressure Control in Patients With Nondiabetic Glomerular Disease

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