Nephrol Dial Transplant. 2011 Feb;26(2):430-7. doi: 10.1093/ndt/gfq635. Epub 2010 Oct 8.
Arteriolosclerosis (microvascular disease) may have a key role not only in driving salt-sensitive hypertension but also in mediating the development of chronic kidney disease, vascular dementia, stroke and coronary heart disease. In this paper, we review the evidence that these latter conditions result from the altered autoregulation that occurs when arterioles become diseased. We also discuss the increasing evidence that dietary intake of sugars rich in fructose may be driving the development of microvascular disease as a consequence of raising intracellular uric acid. We hypothesize that the treatment of microvascular disease may require a multifaceted approach by utilizing agents which aim at blocking of the renin-angiotensin system, reducing oxidative stress, stimulating endothelial nitric oxide production and lowering uric acid levels. Paradoxically, agents that only stimulate nitric oxide, such as oestrogens, may increase the risk of poor outcomes if microvascular disease is not reversed.
小动脉硬化症（微血管疾病）不仅可能在驱动盐敏感型高血压中起关键作用，而且可能在介导慢性肾脏病、血管性痴呆、中风和冠心病的发生发展中起关键作用。在本文中，我们综述了以下证据：当小动脉发生病变时，会出现改变的自动调节，而这些后者的病症就由此产生。我们还讨论了越来越多的证据表明，富含果糖的糖的饮食摄入可能会由于提高细胞内尿酸而导致微血管疾病的发展。我们假设，微血管疾病的治疗可能需要通过利用旨在阻断肾素-血管紧张素系统、降低氧化应激、刺激内皮一氧化氮生成和降低尿酸水平的药物来采取多方面的方法。矛盾的是，如果不逆转微血管疾病，仅刺激一氧化氮的药物（如雌激素）可能会增加不良后果的风险。
