Hypertension and Renal Dysfunction

Jones, Camille A.

doi:10.1097/01.asn.0000070146.29445.d8

Cited by 16 publications

(8 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several investigations have suggested that chronic kidney disease stage is an excellent measure of severity and an accurate predictor of the risk of comorbidity and complications (El Nahas and Bello 2005;Knight et al 2003;Levey et al 2003). Possible refinements to the classification scheme around several issues including the interaction of increasing age with glomerular filtration rate, the value of different disease severity predictors in different patient populations, and the basis of selection of glomerular filtration rate cut-off values for some disease stages are being researched (Jones 2003;Levey et al 2003Levey et al , 2005Obrador et al 2002).…”

Section: Classificationmentioning

confidence: 99%

Adult Chronic Kidney Disease: Neurocognition in Chronic Renal Failure

2009

View full text Add to dashboard Cite

In recent years there has been a keen interest in the neurocognitive sequelae of renal failure and subsequent end-stage renal disease given its increasing prevalence and incidence. This review article summarizes the relevant information on cognitive functioning in chronic kidney disease in adults before the initiation of dialysis, after the initiation of dialysis, and after renal transplantation. In general, compared to pre-dialysis, there is an improvement in cognitive function after the institution of dialysis and further improvement after renal transplantation. Throughout the paper an attempt is made to highlight the importance of considering disease related variables in the neuropsychological assessment of individuals with chronic kidney disease. The paper concludes with a discussion of future avenues of research.

show abstract

Section: Classificationmentioning

confidence: 99%

Adult Chronic Kidney Disease: Neurocognition in Chronic Renal Failure

2009

View full text Add to dashboard Cite

show abstract

“…59 Thus, obese individuals have been found to have an increased renal plasma flow and increased glomerular filtration rates. 60 At the same time, abdominal obesity has also been associated with a decrease in glomerular filtration rates and an increase in albumin excretion.…”

Section: Renal Abnormalities In Obesity Hypertensionmentioning

confidence: 99%

Is There a Rationale for Angiotensin Blockade in the Management of Obesity Hypertension?

Sharma

2004

Hypertension

129

View full text Add to dashboard Cite

Abstract-Obesity, currently affecting Ͼ20% of the adult population in most Western countries, is a major risk factor for the development of hypertension. Hypertension in obese patients is, in the majority of instances, further complicated by the concomitant presence of dyslipidemia and insulin resistance. The latter is reflected by derangement of glucose homeostasis, ranging from hyperinsulinemia to frank type 2 diabetes. Hypertension in obese patients is also associated with an increased risk for left ventricular hypertrophy, endothelial dysfunction, renal hyperfiltration, microalbuminuria, and elevated markers of inflammation. Sodium retention, volume expansion, and increased cardiac output are common findings in obese individuals. These changes are largely attributable to increased activity of the sympathetic nervous system and insufficient suppression of the renin-angiotensin system. Recent data show increased expression of angiotensin II-forming enzymes in adipose tissue, and increased activity of the renin-angiotensin system has recently been implicated in the development of insulin resistance and type 2 diabetes. Accordingly, antihypertensive agents that block the renin-angiotensin system might be a beneficial strategy for treatment of obesity-related hypertension. Both angiotensin-converting enzyme inhibitors and angiotensin type-1 receptor blockers have been associated with favorable metabolic properties and end-organ protection in addition to their antihypertensive effects. Data from ongoing large trials will provide an indication of the protective and preventive effects of these treatment strategies while offering insights into the mechanisms linking obesity, hypertension, and other facets of the metabolic syndrome. Key Words: obesity Ⅲ hypertension, obesity Ⅲ angiotensin Ⅲ renin-angiotensin system Ⅲ angiotensin-converting enzyme Ⅲ diabetes mellitus A bdominal obesity, characterized by the accumulation of visceral adipose tissue, is a major risk factor for the development of hypertension. 1,2 Abdominal obesity is also the principal risk factor for insulin resistance and the development of type 2 diabetes. 3 Hypertension in obese individuals is, therefore, commonly complicated by the concomitant presence of dyslipidemia, hyperinsulinemia, impaired glucose tolerance, and other facets of the metabolic syndrome. 4 Furthermore, abdominal obesity is associated with a number of functional and morphological abnormalities including sodium retention, increased cardiac output, renal hyperfiltration, endothelial dysfunction, left ventricular hypertrophy, microalbuminuria and elevated markers of inflammation. 5,6 It is, therefore, not surprising that obesity is an important predictor of overall cardiovascular morbidity and mortality. 1,2 Sodium retention plays a central role in the development of obesity-related hypertension ( Figure). Thus, obese individuals display a lower natriuretic response to a saline load than normal weight individuals. 7,8 Although the mechanisms by which obesity alters renal function are ...

show abstract

“…hypertension; renal injury; kidney; glomerulus; chronic kidney disease HYPERTENSION IS ONE OF THE leading causes of chronic kidney disease (CKD) that affects nearly 20 million Americans (9,17). Despite effective medications, compliance and drug costs remain a problem, and only a small percentage of patients achieve adequate blood pressure control (9).…”

mentioning

confidence: 99%

Renoprotective effects of anti-TGF-β antibody and antihypertensive therapies in Dahl S rats

Murphy

Dahly-Vernon²,

Dunn

et al. 2012

American Journal of Physiology-Regulatory, Integrative and Comp

View full text Add to dashboard Cite

This study examined the effects of anti-TGF-β antibody (1D11) therapy in Dahl S (S) rats fed a 4% NaCl diet. Baseline renal expression of TGF-β1 and the degree of injury were lower in female than male S rats maintained on a 0.4% NaCl diet. 4% NaCl diet increased mean arterial pressure (MAP), proteinuria, and renal injury to the same extent in both male and female S rats. Chronic treatment with 1D11 had renoprotective effects in both sexes. The ability of 1D11 to oppose the development of proteinuria when given alone or in combination with antihypertensive agents was further studied in 6-wk-old female S rats, since baseline renal injury was less than that seen in male rats. 1D11, diltiazem, and hydrochlorothiazide (HCT) attenuated the development of hypertension, proteinuria, and glomerular injury. 1D11 had no additional effect when given in combination with these antihypertensive agents. We also explored whether 1D11 could reverse renal injury in 9-wk-old male S rats with preexisting renal injury. MAP increased to 197 ± 4 mmHg and proteinuria rose to >300 mg/day after 3 wk on a 4% NaCl diet. Proteinuria was reduced by 30-40% in rats treated with 1D11, HCT, or captopril + 1D11, but the protective effect was lost in rats fed the 4% NaCl diet for 6 wk. Nevertheless, 1D11, HCT, and captopril + 1D11 still reduced renomedullary and cardiac fibrosis. These results indicate that anti-TGF-β antibody therapy reduces renal and cardiac fibrosis and affords additional renoprotection when given in combination with various antihypertensive agents in Dahl S rats.

show abstract

Hypertension and Renal Dysfunction

Cited by 16 publications

References 11 publications

Adult Chronic Kidney Disease: Neurocognition in Chronic Renal Failure

Adult Chronic Kidney Disease: Neurocognition in Chronic Renal Failure

Is There a Rationale for Angiotensin Blockade in the Management of Obesity Hypertension?

Renoprotective effects of anti-TGF-β antibody and antihypertensive therapies in Dahl S rats

Contact Info

Product

Resources

About