Figure 66

Correlation between systolic blood pressure and glomerular injury in rats with remnant kidneys. In these rats, blood pressure was continuously monitored by implanting a blood pressure sensor in the abdominal aorta connected telemetrically to a receiver. The time-averaged blood pressure in rats with remnant kidneys that were untreated or given the angiotensin-converting enzyme inhibitor enalapril or triple therapy (combination of hydralazine, reserpine, and a thiazide diuretic) was correlated with morphologic evidence of glomerular injury. A close correlation was found between the average blood pressure and extent of glomerular injury that developed in these rats. It is proposed that, because of impaired autoregulation in chronic renal disease, elevations in systemic blood pressure are associated with glomerular hypertension in these rats. The higher the systemic pressure, the higher the glomerular pressure is predicted to be and the more glomerular injury is observed. These data provide additional evidence that systemic hypertension produces glomerular injury by causing elevation in glomerular pressure, and that antihy-pertensive therapy reduces injury by reducing glomerular capillary pressure. (From Griffen and coworkers [7]; with permission.)

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