Nash D A
Arch Intern Med. 1977 Nov;137(11):1571-5.
Hypertension occurring in patients with adult polycystic kidney disease (PKD) without substantially decreased glomerular filtration rate (GFRs) has not been sufficiently evaluated. Seven patients with bilateral PKD and serum creatinine clearances greater than 70 ml/min were studied to examine the roles of sodium retention and the renin-angiotensin system in their hypertension. These individuals demonstrated evidence of volume expansion and sodium-dependent hypertension. However, the renin-angiotensin system was not consistently depressed as a consequence, and two of the seven had significantly increased plasma renin activity values. It seems that patients with PKD who had normal GFRs retain rather than waste sodium and may become hypertensive. The contribution of the renin-angiotensin system is variable and seems to be a function of such factors as symmetry of the cystic involvement and the degree of intravascular volume expansion.
在成年多囊肾病（PKD）患者中，肾小球滤过率（GFRs）未显著降低却出现高血压的情况尚未得到充分评估。对7例双侧PKD且血清肌酐清除率大于70 ml/分钟的患者进行了研究，以探讨钠潴留和肾素 - 血管紧张素系统在其高血压中的作用。这些个体表现出容量扩张和钠依赖性高血压的证据。然而，肾素 - 血管紧张素系统并非因此持续受到抑制，7例中有2例血浆肾素活性值显著升高。似乎GFRs正常的PKD患者潴留而非排出钠，并且可能会变得高血压。肾素 - 血管紧张素系统的作用是可变的，似乎是诸如囊性病变对称性和血管内容量扩张程度等因素的函数。
