Sharma B K, Sharma N, Jain S
Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh.
J Indian Med Assoc. 1999 Mar;97(3):91-5; 105.
Over the last decade, a great body of evidence has pointed towards the role of kidneys in the genesis and maintenance of a hypertensive state. There exists a relationship between a rise in the blood pressure and a proportionate increase in the urinary excretion of sodium and water called the pressure-natriuresis curve. Chronic renal diseases are the most common causes of secondary hypertension accounting for 2-5% of all cases of secondary hypertension. The prevalence rate of renovascular hypertension based upon referral patterns range from 0.2% to 10% of hypertensive population. The data provided by the International Registries on end-stage renal disease have suggested that essential hypertension is an important cause of progressive renal damage. The pathological lesion observed in malignant hypertension is fibrinoid necrosis of the small arteries and arterioles. Amongst the armamentarium of antihypertensive drugs calcium channel antagonists and the angiotensin converting enzyme inhibitors have a role in limiting glomerular hypertension. The best modality to prevent and treat renal dysfunction in the presence of hypertension is an adequate and effective control of high blood pressure.
在过去十年中，大量证据表明肾脏在高血压状态的发生和维持中所起的作用。血压升高与钠和水的尿排泄量成比例增加之间存在一种关系，称为压力-利钠曲线。慢性肾脏疾病是继发性高血压最常见的原因，占所有继发性高血压病例的2%至5%。基于转诊模式的肾血管性高血压患病率在高血压人群中为0.2%至10%。国际终末期肾病登记处提供的数据表明，原发性高血压是进行性肾损害的重要原因。恶性高血压中观察到的病理病变是小动脉和微动脉的纤维蛋白样坏死。在抗高血压药物中，钙通道拮抗剂和血管紧张素转换酶抑制剂在限制肾小球高血压方面发挥作用。在高血压情况下预防和治疗肾功能障碍的最佳方式是充分有效地控制高血压。
