Scherer B
Medizinische Klinik Innenstadt, Universität München.
Urologe A. 1988 Nov;27(6):307-12.
Renal disease has been recognized as both a cause and a consequence of hypertension. Renal hypertension may be of vascular and nonvascular origin. Generally, the prevalence of hypertension increases with decreasing renal function, including more than 90% of patients with terminal renal failure. However, hypertension is more often found in glomerular than in interstitial disease. The pathomechanisms operative in renal hypertension are sodium retention with concomitant volume expansion, an increase in plasma renin activity or a combination of both factors. While mechanical intervention is usually tried in renovascular hypertension and in the rare cases with "urological" causes, no causal therapy is possible in most cases of renoparenchymal disease. However, as the normalization of blood pressure is the best proved way to stop or at least retard the progression of renoparenchymal disease, pharmacological intervention is mandatory even if the medication sometimes has side effects.
肾脏疾病一直被认为既是高血压的病因，也是其后果。肾性高血压可能源于血管性和非血管性因素。一般来说，高血压的患病率随肾功能下降而增加，终末期肾衰竭患者中该患病率超过90%。然而，高血压在肾小球疾病中比在间质性疾病中更常见。肾性高血压的发病机制包括钠潴留伴血容量扩张、血浆肾素活性增加或两者兼而有之。虽然对于肾血管性高血压以及极少数由“泌尿系统”原因导致的高血压通常尝试进行机械干预，但在大多数肾实质疾病病例中无法进行病因治疗。然而，由于血压正常化是阻止或至少延缓肾实质疾病进展的最有效方法，即使药物有时有副作用，药物干预也是必要的。
