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Renal volume, renin-angiotensin-aldosterone system, hypertension, and left ventricular hypertrophy in patients with autosomal dominant polycystic kidney disease.
J Am Soc Nephrol. 2009 Sep; 20(9):1888-93.JA

Abstract

The relationship between renal volume and hypertension in autosomal dominant polycystic kidney disease (ADPKD) occurs in childhood. Hypertension is associated not only with increased kidney volume but also with significantly increased left ventricular mass index. Moreover, this increase in left ventricular mass index occurs in children who have ADPKD with borderline hypertension (75th to 95th percentile) and is prevented with angiotensin-converting enzyme inhibitor (ACEI) monotherapy. Progression from borderline to overt hypertension (> or =95th percentile) occurs during a 5-yr follow-up in approximately 50% of children with ADPKD and borderline hypertension. Renal cyst enlargement in ADPKD in adults is associated with stimulation of both the circulating and intrarenal renin-angiotensin-aldosterone system. In addition to hypertension, the resultant angiotensin in ADPKD is a pivotal factor in cyst proliferation and expansion, increased sympathetic and endothelin activity, oxidant injury, and fibrosis. There is a close correlation between the level of hypertension, left ventricular hypertrophy, deterioration of GFR, and the progressive enlargement of the cystic kidneys in adult ADPKD. Randomized clinical investigation indicates that ACEI and a BP goal of 120/80 mmHg are associated in a 7-yr study to reverse left ventricular hypertrophy. The effect of renin-angiotensin-aldosterone system inhibition with dual blockade, ACEI and angiotensin receptor antagonists, on renal volume and kidney function is under study in the Halt Progression of Polycystic Kidney Disease (HALT PKD) trial.

Authors+Show Affiliations

Department of Medicine, University of Colorado Denver, Denver, Colorado, USA. robert.schrier@ucdenver.edu

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Review

Language

eng

PubMed ID

19696226

Citation

Schrier, Robert W.. "Renal Volume, Renin-angiotensin-aldosterone System, Hypertension, and Left Ventricular Hypertrophy in Patients With Autosomal Dominant Polycystic Kidney Disease." Journal of the American Society of Nephrology : JASN, vol. 20, no. 9, 2009, pp. 1888-93.
Schrier RW. Renal volume, renin-angiotensin-aldosterone system, hypertension, and left ventricular hypertrophy in patients with autosomal dominant polycystic kidney disease. J Am Soc Nephrol. 2009;20(9):1888-93.
Schrier, R. W. (2009). Renal volume, renin-angiotensin-aldosterone system, hypertension, and left ventricular hypertrophy in patients with autosomal dominant polycystic kidney disease. Journal of the American Society of Nephrology : JASN, 20(9), 1888-93. https://doi.org/10.1681/ASN.2008080882
Schrier RW. Renal Volume, Renin-angiotensin-aldosterone System, Hypertension, and Left Ventricular Hypertrophy in Patients With Autosomal Dominant Polycystic Kidney Disease. J Am Soc Nephrol. 2009;20(9):1888-93. PubMed PMID: 19696226.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Renal volume, renin-angiotensin-aldosterone system, hypertension, and left ventricular hypertrophy in patients with autosomal dominant polycystic kidney disease. A1 - Schrier,Robert W, Y1 - 2009/08/20/ PY - 2009/8/22/entrez PY - 2009/8/22/pubmed PY - 2009/10/3/medline SP - 1888 EP - 93 JF - Journal of the American Society of Nephrology : JASN JO - J. Am. Soc. Nephrol. VL - 20 IS - 9 N2 - The relationship between renal volume and hypertension in autosomal dominant polycystic kidney disease (ADPKD) occurs in childhood. Hypertension is associated not only with increased kidney volume but also with significantly increased left ventricular mass index. Moreover, this increase in left ventricular mass index occurs in children who have ADPKD with borderline hypertension (75th to 95th percentile) and is prevented with angiotensin-converting enzyme inhibitor (ACEI) monotherapy. Progression from borderline to overt hypertension (> or =95th percentile) occurs during a 5-yr follow-up in approximately 50% of children with ADPKD and borderline hypertension. Renal cyst enlargement in ADPKD in adults is associated with stimulation of both the circulating and intrarenal renin-angiotensin-aldosterone system. In addition to hypertension, the resultant angiotensin in ADPKD is a pivotal factor in cyst proliferation and expansion, increased sympathetic and endothelin activity, oxidant injury, and fibrosis. There is a close correlation between the level of hypertension, left ventricular hypertrophy, deterioration of GFR, and the progressive enlargement of the cystic kidneys in adult ADPKD. Randomized clinical investigation indicates that ACEI and a BP goal of 120/80 mmHg are associated in a 7-yr study to reverse left ventricular hypertrophy. The effect of renin-angiotensin-aldosterone system inhibition with dual blockade, ACEI and angiotensin receptor antagonists, on renal volume and kidney function is under study in the Halt Progression of Polycystic Kidney Disease (HALT PKD) trial. SN - 1533-3450 UR - https://www.unboundmedicine.com/medline/citation/19696226/Renal_volume_renin_angiotensin_aldosterone_system_hypertension_and_left_ventricular_hypertrophy_in_patients_with_autosomal_dominant_polycystic_kidney_disease_ L2 - http://jasn.asnjournals.org/cgi/pmidlookup?view=long&pmid=19696226 DB - PRIME DP - Unbound Medicine ER -