Does essential hypertension lead to renal failure?

Systemic hypertension can lead to renal failure in blacks. The key lesion is severe intimal thickening in interlobular arteries without fibrinoid necrosis. Hypertensive endothelial injury is the likely root cause of the intimal thickening. High potassium diets prevent wall thickening of small renal arteries and arterioles in hypertensive Dahl S rats and also greatly reduce both medial and intimal thickening of the aorta and mesenteric and carotid arteries in spontaneously hypertensive stroke-prone rats. In view of this, it is quite likely that the low potassium diet characteristically seen in blacks exaggerates the hypertensive intimal thickening. A high potassium diet could possibly preserve these arteries and avert much renal failure.