Salt-Sensitive Hypertension in Chronic Kidney Disease: Distal Tubular Mechanisms.

Salt-Sensitive Hypertension in Chronic Kidney Disease: Distal Tubular Mechanisms. Am J Physiol Renal Physiol. 2020 Sep 28;: Authors: Bovee DM, Cuevas CA, Zietse R, Danser AHJ, Mirabito Colafella KM, Hoorn EJ Abstract Chronic kidney disease (CKD) causes salt-sensitive hypertension that is often resistant to treatment and contributes to the progression of kidney injury and cardiovascular disease. A better understanding of the mechanisms contributing to salt-sensitive hypertension in CKD is essential to improve these outcomes. This review critically explores these mechanisms by focusing on how CKD affects distal nephron sodium (Na+) reabsorption. CKD causes glomerulotubular imbalance with reduced proximal Na+ reabsorption and increased distal Na+ delivery and reabsorption. Aldosterone secretion further contributes to distal Na+ reabsorption in CKD and is not only mediated by renin and potassium, but also by metabolic acidosis, endothelin-1, and vasopressin. CKD also activates the intrarenal renin-angiotensin system (RAS) generating intratubular angiotensin II to promote distal Na+ reabsorption. High dietary Na+ intake in CKD contributes to Na+ retention by an aldosterone-independent activation of the mineralocorticoid receptor mediated through Rac1. High dietary Na+ also produces an inflammatory response mediated by T helper 17 cells and cytokines increasing distal Na+ transport. CKD is often accompanied by proteinuria, which contains plasmin capable of act...
Source: American Journal of Physiology. Renal Physiology - Category: Physiology Authors: Tags: Am J Physiol Renal Physiol Source Type: research

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Source: Journal of Nephrology - Category: Urology & Nephrology Authors: Tags: J Nephrol Source Type: research
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Source: Pediatric Nephrology - Category: Urology & Nephrology Source Type: research
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Source: American Journal of Perinatology - Category: Perinatology & Neonatology Authors: Tags: Original Article Source Type: research
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Source: Frontiers in Physiology - Category: Physiology Source Type: research
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Source: Journal of Aging Research - Category: Geriatrics Tags: J Aging Res Source Type: research
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Source: Clinical Nephrology - Category: Urology & Nephrology Authors: Tags: Clin Nephrol Source Type: research
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Source: Blood Pressure Monitoring - Category: Cardiology Tags: Clinical Methods Source Type: research
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Source: Pediatric Nephrology - Category: Urology & Nephrology Source Type: research
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Source: Journal of Korean Medical Science - Category: Biomedical Science Tags: J Korean Med Sci Source Type: research
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