Hellmann H, Davis J M, Thurau K
Physiological Institute, University of Munich, Germany.
Kidney Int Suppl. 1998 Sep;67:S211-2. doi: 10.1046/j.1523-1755.1998.06750.x.
The kidney has long been attributed a key role in the pathogenesis of hypertension. Reduction of filtration area by glomerular loss is regarded currently as a major causative mechanism. Here we analyze the relationship between glomerulus number and blood pressure (BP) in a new model of genetic hypertension and the Prague hypertensive rat (PHR) and the Prague normotensive rat (PNR). Glomerular numbers were determined in 7- to 53-week-old PNR and PHR, and the correlation with conscious systolic BP was analyzed. PHR had significantly higher BP but 19% fewer glomeruli than PNR. Glomerular number correlated (partial correlation analysis, controlling for effects of body weight, age, and kidney weight) significantly (P < 0.01, r2 = 0.46) with BP in male PHR but not in female PHR or in PNR. Moreover, subgroups of PHR and PNR selected for the same mean BP showed the same differences in glomerular counts, and subgroups selected for the same mean glomerular count showed the same differences in BP as the whole group. Reduced glomerular numbers and BP seem not to be causally related to BP in PHR older than seven weeks. Other mechanisms, such as genetically determined changes in transporter and receptor proteins, vascular abnormalities, and humoral mechanisms, must be considered.
长期以来，肾脏一直被认为在高血压发病机制中起关键作用。目前，肾小球丢失导致滤过面积减少被视为主要致病机制。在此，我们在一种新的遗传性高血压模型以及布拉格高血压大鼠（PHR）和布拉格正常血压大鼠（PNR）中分析肾小球数量与血压（BP）之间的关系。测定了7至53周龄的PNR和PHR的肾小球数量，并分析了其与清醒收缩压的相关性。PHR的血压显著高于PNR，但肾小球数量比PNR少19%。在雄性PHR中，肾小球数量与血压显著相关（偏相关分析，控制体重、年龄和肾脏重量的影响，P < 0.01，r2 = 0.46），而在雌性PHR或PNR中则无此相关性。此外，选择具有相同平均血压的PHR和PNR亚组，其肾小球计数差异相同，选择具有相同平均肾小球计数的亚组，其血压差异与整个组相同。在7周龄以上的PHR中，肾小球数量减少和血压似乎并非因果相关。必须考虑其他机制，如转运蛋白和受体蛋白的基因决定变化、血管异常和体液机制。
