Role of renal hemodynamics in the exaggerated natriuresis of essential hypertension.

Abstract:

:Extracellular fluid volume expansion is known to produce exaggerated natriuresis in essential hypertension. In order to assess the role of hemodynamic and intrarenal physical factors upon natriuretic response to central volume expansion, two hour water immersion (WI) experiments were made in six uncomplicated essential hypertensives and six normotensive healthy controls. Before and during WI we measured mean arterial pressure (MAP), urine flow (V/min), sodium (UNaV) and potassium (UKV) excretion, glomerular filtration rate (GFR), effective renal plasma flow (ERPF) and intrarenal (wedged) venous pressure (IRVP). In comparison with normotensive controls, the exaggerated natriuretic response in hypertensives (P less than 0.05 for UNaV during WI) was associated with an enhanced vasodilating response as demonstrated by a greater increase in ERPF (P less than 0.05) and by a more pronounced fall in calculated renal precapillary resistances (P less than 0.05). A more significant increase in IRVP was found in hypertensive group (P less than 0.05). Glomerular filtration rate (GFR) did not change in either group during WI. MAP, unchanged in normotensives, was significantly reduced in hypertensives (P less than 0.05), while remaining in the hypertensive range. These findings suggest that intrarenal physical factors play a major role in determining the exaggerated natriuresis during WI in hypertensive man.

journal_name

Kidney Int

journal_title

Kidney international

authors

Coruzzi P,Musiari L,Biggi A,Ravanetti C,Vallisa D,Montanari A,Novarini A

doi

10.1038/ki.1988.79

subject

Has Abstract

pub_date

1988-04-01 00:00:00

pages

875-80

issue

4

eissn

0085-2538

issn

1523-1755

pii

S0085-2538(15)34252-6

journal_volume

33

pub_type

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