Filtration Surface Area, Salt Intake and Hypertension

Brenner, Barry M.; Anderson, Sharon

doi:10.1159/000417729

Cited by 3 publications

(1 citation statement)

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“…[6][7][8][19][20][21][22]25,29,30,66,67,69,77 Glomerular pressure is the only controllable parameter among the factors that determine the GFR under filtration pressure disequilibrium. In turn, glomerular capillary pressure is determined by both the afferent-to-efferent arteriolar resistance ratio and the systemic mean arterial pressure (Fig.…”

Section: Glomerular Hypertension: the Second Step Of Glomerular Functmentioning

confidence: 99%

Glomerular function reserve and sodium sensitivity

Kimura

2005

Clin Exp Nephrol

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In clinical nephrology, the glomerular filtration rate (GFR) has been recognized as the golden standard to assess renal function. However, a normal GFR does not necessarily mean normal filtration capability of the kidneys, because impaired filtration capability can be compensated for by elevating glomerular hydraulic pressure. Therefore, an early phase of glomerular dysfunction cannot be detected by the baseline GFR alone. On the other hand, glomerular capillary hypertension is widely recognized as one of the strong risk factors for the progression of nephropathies. Now, it is very important to imagine glomerular hemodynamics in each patient with nephropathy for detecting early dysfunction, as well as for evaluating risk factors. Here, I would like to summarize the current status of how an early phase of renal dysfunction can be detected in clinical practice. I truly anticipate that new methods to assess glomerular hemodynamics in humans will be developed in the near future.

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Section: Glomerular Hypertension: the Second Step Of Glomerular Functmentioning

confidence: 99%

Glomerular function reserve and sodium sensitivity

Kimura

2005

Clin Exp Nephrol

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References

1995

The Clinical Biology of Sodium

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Implications of the linear pressure–natriuresis relationship and importance of sodium sensitivity in hypertension

Kimura

Brenner

1997

Journal of Hypertension

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Although the concept of the pressure-natriuresis curve is very clear, considerable confusion concerning its importance and utility in understanding the pathophysiology of hypertension persists. We recently showed that the pressure-natriuresis curve could be considered linear. In this brief review, we would like to stress the advantages of treating it as a line. Its linear approximation simplifies understanding of the sodium sensitivity of the blood pressure and mechanisms of hypertension. The blood pressure can be expressed as the sum of two components: the non-sodium-sensitive component determined by the x intercept of the pressure-natriuresis curve and the sodium sensitive one determined by the product of the reciprocal of the slope and the amount of sodium intake. Theoretically, it can be affected in two different ways to cause hypertension; either a parallel shift along the blood pressure axis toward a higher blood pressure level due to the increase in the x intercept or a decrease in the slope. The parallel shift induces non-sodium-sensitive hypertension, whereas the decrease in slope induces sodium-sensitive hypertension. Thus, the linear approximation makes the definition of the sodium sensitivity of the blood pressure very clear and, furthermore, suggests that mechanisms of hypertension can be clarified if the determinants of the x intercept and the slope of the pressure-natriuresis curve are known. A clear definition of sodium sensitivity allows us to study its importance as a marker of a greater risk of renal and cardiovascular complications.

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Filtration Surface Area, Salt Intake and Hypertension

Cited by 3 publications

References 0 publications

Glomerular function reserve and sodium sensitivity

Glomerular function reserve and sodium sensitivity

References

Implications of the linear pressure–natriuresis relationship and importance of sodium sensitivity in hypertension

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