Systolic blood pressure as the trigger for the renal myogenic response: protective or autoregulatory?

Abstract

These new findings are consistent with recent data indicating that it is the systolic blood pressure elevations that most closely correlate with target organ damage. The fact that the myogenic mechanism is also a necessary component of renal autoregulation may explain the strong linkage between autoregulatory impairment and increased susceptibility to hypertensive injury.

Increased susceptibility to hypertensive renal disease in streptozotocin-treated diabetic rats is not modulated by salt intake

“…Only one mechanism, autoregulation, protects glomeruli from hypertension and blood pressure (BP) fluctuations [9]. Reduced efficiency of autoregulation increases susceptibility to, and rate of progression of, hypertensive nephropathy [9][10][11]. It is often considered that autoregulation is impaired in diabetes, and diabetic hyperfiltration has been attributed to enhanced transmission of systemic pressure to glomeruli [2,12,13].…”

βENaC is required for whole cell mechanically gated currents in renal vascular smooth muscle cells

“…In the kidney, it is an important mechanism of renal autoregulation, critical for maintaining normal renal blood flow and glomerular filtration rate with changes in perfusion pressure. Recent studies also suggest myogenic constriction plays an important role in protecting against pressure-related renal injury by preventing transmission of systemic pressure swings to delicate renal microvasculature (28,29,42).There are at least three ion channels that play important roles in the myogenic response; mechanically gated ion channels, voltage-gated calcium channels (VGCC), and large conductance calcium activated potassium (BK) channels. The current understanding is that intravascular pressure induces a longitudinal stretch of vascular smooth muscle cells (VSMCs) that are circumferentially arranged in the vessel wall.…”

“…In the kidney, it is an important mechanism of renal autoregulation, critical for maintaining normal renal blood flow and glomerular filtration rate with changes in perfusion pressure. Recent studies also suggest myogenic constriction plays an important role in protecting against pressure-related renal injury by preventing transmission of systemic pressure swings to delicate renal microvasculature (28,29,42).…”

Eutrophic Remodeling of Small Arteries in Type 1 Diabetes Mellitus Is Enabled by Metabolic Control

“…3,4 Recently, this difference in response to blood pressure (BP) has been suggested as an explanation for the propensity of patients to develop target organ damage in diabetes mellitus. 5,6 It has been postulated that the inability of the small artery to reduce the lumen diameter in response to central hypertension may result in the transmission of elevated pressures downstream to susceptible organs, eg, the eye or the kidney. [5][6][7] This appears to be supported by clinical observations, which have shown that the retinal vessel caliber is larger in patients with diabetes mellitus.…”

“…5,6 It has been postulated that the inability of the small artery to reduce the lumen diameter in response to central hypertension may result in the transmission of elevated pressures downstream to susceptible organs, eg, the eye or the kidney. [5][6][7] This appears to be supported by clinical observations, which have shown that the retinal vessel caliber is larger in patients with diabetes mellitus. 8 Also, in patients with type 1 diabetes mellitus, a larger vessel caliber can predict progression to both nephropathy 9 and retinopathy.…”