| Renal volume, renin-angiotensin-aldosterone system, hypertension, and left ventricular hypertrophy in patients with autosomal dominant polycystic kidney disease. | |
MedLine Citation:
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PMID: 19696226 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The relationship between renal volume and hypertension in autosomal dominant polycystic kidney disease (ADPKD) occurs in childhood. Hypertension is associated not only with increased kidney volume but also with significantly increased left ventricular mass index. Moreover, this increase in left ventricular mass index occurs in children who have ADPKD with borderline hypertension (75th to 95th percentile) and is prevented with angiotensin-converting enzyme inhibitor (ACEI) monotherapy. Progression from borderline to overt hypertension (> or =95th percentile) occurs during a 5-yr follow-up in approximately 50% of children with ADPKD and borderline hypertension. Renal cyst enlargement in ADPKD in adults is associated with stimulation of both the circulating and intrarenal renin-angiotensin-aldosterone system. In addition to hypertension, the resultant angiotensin in ADPKD is a pivotal factor in cyst proliferation and expansion, increased sympathetic and endothelin activity, oxidant injury, and fibrosis. There is a close correlation between the level of hypertension, left ventricular hypertrophy, deterioration of GFR, and the progressive enlargement of the cystic kidneys in adult ADPKD. Randomized clinical investigation indicates that ACEI and a BP goal of 120/80 mmHg are associated in a 7-yr study to reverse left ventricular hypertrophy. The effect of renin-angiotensin-aldosterone system inhibition with dual blockade, ACEI and angiotensin receptor antagonists, on renal volume and kidney function is under study in the Halt Progression of Polycystic Kidney Disease (HALT PKD) trial. |
Authors:
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Robert W Schrier |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Review Date: 2009-08-20 |
Journal Detail:
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Title: Journal of the American Society of Nephrology : JASN Volume: 20 ISSN: 1533-3450 ISO Abbreviation: J. Am. Soc. Nephrol. Publication Date: 2009 Sep |
Date Detail:
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Created Date: 2009-09-01 Completed Date: 2009-10-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9013836 Medline TA: J Am Soc Nephrol Country: United States |
Other Details:
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Languages: eng Pagination: 1888-93 Citation Subset: IM |
Affiliation:
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Department of Medicine, University of Colorado Denver, Denver, Colorado, USA. robert.schrier@ucdenver.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Humans Hypertension, Renal / complications*, pathology*, physiopathology Hypertrophy, Left Ventricular / complications* Kidney / pathology, physiopathology Polycystic Kidney, Autosomal Dominant / complications*, pathology*, physiopathology Renin-Angiotensin System / physiology* |
| Grant Support | |
ID/Acronym/Agency:
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5R01 DK 058793/DK/NIDDK NIH HHS; P01 DK 19928/DK/NIDDK NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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