Vnitr Lek 2021, 67(8):479-484 | DOI: 10.36290/vnl.2021.123

Renal parenchymal hypertension: relevant new aspects

Jan Vachek^{1, 2}, Oskar Zakiyanov¹, Kateřina Oulehle², Hana Ciferská³, Vladimír Tesař¹

¹ Klinika nefrologie 1. LF UK a VFN v Praze

² Interní oddělení a hemodialyzační středisko, Klatovská nemocnice, a. s.

³ Revmatologický ústav a Revmatologická klinika 1. LF UK, Praha

Renal parenchymal disease is the most common cause of secondary hypertension, accounting for up to 5% cases of all cases of systemic hypertension. Renal parenchymal hypertension occurs as a complication of a wide variety of glomerular and tubulointerstitial diseases and may aggravate the decline of kidney function. The pathophysiology of renal parenchymal hypertension represents a combined interaction of the impaired sodium handling leading to volume expansion, alteration of the renin-angiotensin system, abnormalities in endogenous vasodepressor compounds and possibly enhanced activity of vasoactive substances. Renal parenchymal hypertension can occur in acute and chronic kidney disease, manifesting early in the renal function impairment. It often requires complex pharmacological treatment of blood pressure and is prognostically unfavorable in terms of cardiovascular and renal complications. This form of secondary hypertension can often be successfully treated by therapy of the underlying renal disease. In case of insufficient blood pressure compensation, renal impairment progresses. The aim of this paper is to give a brief overview of renoparenchymatous hypertension, current diagnostic possibilities and principles of therapy.

Keywords: chronic kidney disease, renoparenchymatous hypertension, diabetic kidney disease, arterial hypertension.

Published: December 9, 2021  Show citation