Document Detail

Hypertension in renal parenchymal disease: why is it so resistant to treatment?
MedLine Citation:
PMID:  16528245     Owner:  NLM     Status:  MEDLINE    
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.
V M Campese; N Mitra; D Sandee
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Kidney international     Volume:  69     ISSN:  0085-2538     ISO Abbreviation:  Kidney Int.     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-03-10     Completed Date:  2006-06-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  967-73     Citation Subset:  IM    
Department of Medicine, Division of Nephrology, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA.
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MeSH Terms
Antihypertensive Agents / therapeutic use*
Arteries / pathology,  physiopathology
Chronic Disease
Circadian Rhythm / physiology
Drug Resistance / physiology
Endothelins / physiology
Endothelium, Vascular / physiopathology
Hypertension / drug therapy*,  etiology,  physiopathology*
Iatrogenic Disease
Kidney Diseases / complications*,  physiopathology*
Oxidative Stress / physiology
Renin-Angiotensin System / physiology
Sleep Apnea Syndromes / complications,  physiopathology
Sympathetic Nervous System / physiopathology
Reg. No./Substance:
0/Antihypertensive Agents; 0/Endothelins

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