Hypertension in renal parenchymal disease: Why is it so resistant to treatment?

被引：89

作者：

Campese, VM ^{[1
]}

Mitra, N ^{[1
]}

Sandee, D ^{[1
]}

机构：

[1] Univ So Calif, Keck Sch Med, Dept Med, Div Nephrol, Los Angeles, CA 90033 USA

来源：

KIDNEY INTERNATIONAL | 2006年 / 69卷 / 06期

关键词：

hypertension; kidney disease; sympathetic nervous system; endothelin; nitric oxide; erythropoietin; sleep apnea; renal ischemia; oxidative stress;

D O I：

10.1038/sj.ki.5000177

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

The association between hypertension and chronic renal disease is well known. The pathogenesis of hypertension in patients with chronic kidney disease (CKD) is complex and multifactorial, which may explain why it is resistant to treatment. The traditional paradigm is that hypertension in CKD is due either to an excess of intravascular volume (volume dependent) or to excessive activation of the renin -angiotensin system in relation to the state of sodium/volume balance (renin-dependent hypertension). This review focuses on the importance of less established mechanisms, such as increased activity of the sympathetic nervous system, increased endothelin production, decreased availability of endothelium-derived vasodilators and structural changes of the arteries, renal ischemia, and sleep apnea.

引用

页码：967 / 973

页数：7

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