In 1939, Irwin Page performed an experiment in a dog model in which one kidney was wrapped in cellophane. The resultant external compression on the kidney resulted in elevated renin-angiotensin-aldosterone levels and severe hypertension. Over time, a loss…
In recent years, there has been the suggestion that thiazide diuretics–long considered a front-line therapy for hypertension based on the ALLHAT study and others–may increase the risk of diabetes. Subsequent retrospective analysis of other major historical cohorts by…
Natriuresis is the process by which sodium is excreted in the urine; this process is regulated (in part at least) by the natriuretic peptides ANP and BNP (there is also a CNP, which appears to have direct effects…
The private company CVRx has developed an interesting method under investigation for blood pressure control in highly refractory hypertensive patients. The approach consists of a surgical implant of electrodes at the carotid sinus; stimulation at the sinus results…
Scleroderma is a chronic autoimmune disease characterized by fibrosis and hardening of the skin and other organs–occasionally involving the kidney to such an extent that dialysis becomes necessary. There are two main flavors of scleroderma: (1) the CREST…
The Brenner Hypothesis–developed by Barry Brenner of the Brigham and Women’s Hospital, author of the well-known Brenner & Rector “The Kidney” textbook–states that individuals with a congenital reduction in nephron number have a much greater likelihood of developing…
One of the as-yet unresolved major controversies in nephrology is whether or not the entity “hypertensive nephropathy” really exists. Certainly there are a large percentage of the dialysis population who do not have diabetic nephropathy, glomerulonephritis, nephrotic syndrome,…
Managing hypertension in pregnancy is difficult in the sense that there is not a lot of data to guide us. Most of the drugs listed as “safe during pregnancy” are considered so largely based on many years of…
Keeping with our theme of uric acid from yesterday: Do elevated uric acid levels play a causative role in essential hypertension? I just finished attending the Renal Grand Rounds at Beth Israel-Deaconess Hospital featuring Dr. Rick Johnson, a…
Glucocorticoid-Remediable Aldosteronism (GRA) is an inherited autosomal dominant disorder which causes early-onset (often childhood) high blood pressure, often occuring in individuals with Celtic ancestry. It typically presents with standard symptoms of aldosteronism (hypertension, hypokalemia, and metabolic alkalosis) with…
