Mechanisms of hypertensive glomerular injury

Jonathan P. Tolins, Pamela Shultz, Leopoldo Raij

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Systemic hypertension complicates the course of most patients with chronic renal failure and accelerates the progression of experimental and clinical glomerular disease. Based on recent experimental studies, it is suggested that at similar levels of systemic hypertension, glomerular injury only develops when pre-glomerular resistances are ineffective, thus allowing the development of glomerular hypertension. The mechanisms by which the hemodynamic stress of elevated intracapillary flows and pressures leads to progressive glomerular damage, particularly to the development of focal glomerulosclerosis is currently unknown. Endothelial cell injury, increased mesangial traffic or trapping of macromolecules and epithelial cell injury, or a combination, appear to occur early, followed by in situ inflammatory and microthrombotic mechanisms. This may explain why various therapeutic approaches, whether dietary or pharmacologic, can have salutory effects despite their diverse mechanisms of action.

Original languageEnglish
Pages (from-to)54-58
Number of pages5
JournalThe American journal of cardiology
Volume62
Issue number11
DOIs
StatePublished - Oct 5 1988
Externally publishedYes

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Hypertension
Wounds and Injuries
Focal Segmental Glomerulosclerosis
Chronic Kidney Failure
Endothelial Cells
Hemodynamics
Epithelial Cells
Pressure
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Mechanisms of hypertensive glomerular injury. / Tolins, Jonathan P.; Shultz, Pamela; Raij, Leopoldo.

In: The American journal of cardiology, Vol. 62, No. 11, 05.10.1988, p. 54-58.

Research output: Contribution to journalArticle

Tolins, Jonathan P. ; Shultz, Pamela ; Raij, Leopoldo. / Mechanisms of hypertensive glomerular injury. In: The American journal of cardiology. 1988 ; Vol. 62, No. 11. pp. 54-58.
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