Ardiles Leopoldo, Mezzano Sergio
Unidad de Nefrología, Instituto de Medicina, Universidad Austral de Chile, Valdivia, Chile.
Rev Med Chil. 2010 Jul;138(7):862-7. doi: 10.4067/s0034-98872010000700012.
An important proportion of patients with essential hypertension are salt sensitive, defined as those who experience significant blood pressure changes according to the amount of salt intake. They have a disturbance in the pressure induced natriuresis mechanism and their kidneys have functional and morphological alterations consistent with an acquired tubulointerstitial alteration, afferent arteriole damage and alteration of peritubular capillaries. All these alterations lead to disturbances in sodium load excretion under normal pressures. There is also an associated activation of kidney vasoconstrictor/salt retaining systems and a reduction in the vasodilator/salt eliminating mechanisms. These alterations, that originate early in life, generate a new blood pressure level, that corrects natriuresis at the expense of a sustained hypertension.
相当一部分原发性高血压患者对盐敏感，即那些根据盐摄入量会出现显著血压变化的患者。他们的压力诱导性利钠机制存在紊乱，其肾脏具有与后天性肾小管间质改变、入球小动脉损伤及肾小管周围毛细血管改变相一致的功能和形态学改变。所有这些改变导致在正常压力下钠负荷排泄出现紊乱。还存在相关的肾血管收缩/保盐系统激活以及血管舒张/排盐机制减弱。这些在生命早期就出现的改变产生了一个新的血压水平，该血压水平以持续性高血压为代价纠正利钠作用。
