Frame Alissa A, Wainford Richard D
Department of Pharmacology & Experimental Therapeutics and The Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA, USA.
Kidney Res Clin Pract. 2017 Jun;36(2):117-131. doi: 10.23876/j.krcp.2017.36.2.117. Epub 2017 Jun 30.
The pathophysiology of hypertension, which affects over 1 billion individuals worldwide, involves the integration of the actions of multiple organ systems, including the kidney. The kidney, which governs sodium excretion via several mechanisms including pressure natriuresis and the actions of renal sodium transporters, is central to long term blood pressure regulation and the salt sensitivity of blood pressure. The impact of renal sodium handling and the salt sensitivity of blood pressure in health and hypertension is a critical public health issue owing to the excess of dietary salt consumed globally and the significant percentage of the global population exhibiting salt sensitivity. This review highlights recent advances that have provided new insight into the renal handling of sodium and the salt sensitivity of blood pressure, with a focus on genetic, inflammatory, dietary, sympathetic nervous system and oxidative stress mechanisms that influence renal sodium excretion. Increased understanding of the multiple integrated mechanisms that regulate the renal handling of sodium and the salt sensitivity of blood pressure has the potential to identify novel therapeutic targets and refine dietary guidelines designed to treat and prevent hypertension.
高血压影响着全球超过10亿人，其病理生理学涉及多个器官系统（包括肾脏）活动的整合。肾脏通过包括压力性利钠及肾钠转运体作用等多种机制来控制钠排泄，在长期血压调节及血压盐敏感性方面起着核心作用。鉴于全球范围内膳食盐摄入量过多以及全球相当比例的人口表现出盐敏感性，肾钠处理及血压盐敏感性对健康和高血压的影响是一个关键的公共卫生问题。本综述着重介绍了近期取得的进展，这些进展为肾钠处理及血压盐敏感性提供了新的见解，重点关注影响肾钠排泄的遗传、炎症、饮食、交感神经系统及氧化应激机制。对调节肾钠处理及血压盐敏感性的多种整合机制的进一步了解，有可能确定新的治疗靶点并完善旨在治疗和预防高血压的饮食指南。
