Beaufils M
Hôpital Tenon, service de médecine interne, Paris.
Arch Mal Coeur Vaiss. 2006 Jul-Aug;99(7-8):693-6.
The kidney has a key role in blood pressure control, and an abnormal regulation of sodium balance is involved in essential hypertension. It has been suggested that a reduced nephron number at birth could be one possible mechanism. Indeed various strains of hypertensive animals exhibit a reduced nephron number. In human beings, two autopsy studies have clearly shown a lower (about 50%) nephron number in hypertensive subjects. The glomeruli are also enlarged, indicating hyperfiltration. This could be the cause of both high blood pressure and later nephrosclerosis. A low number of nephrons is part of the perinatal programming which occurs together with fetal growth retardation, and this has been reproduced experimentally. There is a negative correlation between birth weight and glomerular number. Such a situation is associated with a largely increased risk of cardiovascular complications in adulthood.
肾脏在血压控制中起着关键作用,钠平衡的异常调节与原发性高血压有关。有人提出,出生时肾单位数量减少可能是一种可能的机制。事实上,各种高血压动物品系都表现出肾单位数量减少。在人类中,两项尸检研究清楚地表明,高血压患者的肾单位数量较低(约减少50%)。肾小球也会增大,表明存在超滤过。这可能是高血压和后期肾硬化的原因。肾单位数量少是围产期编程的一部分,它与胎儿生长受限同时发生,并且这已在实验中得到重现。出生体重与肾小球数量之间存在负相关。这种情况与成年期心血管并发症风险大幅增加有关。