[Pathogenesis of renal failure in hypertension. The role of genetic factors, low weight at birth and endothelial dysfunction].

Nephrosclerosis is usually diagnosed in patients with essential hypertension with no or mild proteinuria and no urinary abnormalities. Microalbuminuria is considered to be a marker of high risk for progressive renal disease in patients with diabetes mellitus but there is still no solid evidences that this alteration entails an adverse renal prognosis in essential hypertension. Independently of hypertension, nephrosclerosis is associated with endothelial dysfunction and evidence is accruing that genetic factors and a low number of nephrons at birth are important determinants of this disease.