RENAL-FUNCTION IN PRIMARY HYPERTENSION

Studies of kidney cross-transplantation in the Milan hypertensive strain of rats (MHS) and in its control strain (MNS) have demonstrated that the kidney has a causal role in the development of hypertension in this animal model. The same result was obtained in two other strains of rats with genetic hypertension. Patients receiving a kidney from a donor with hypertensive parents require more antihypertensive therapy than recipients of a kidney from a donor with a normotensive family. When MHS rats and a subset of patients with primary hypertension were compared with their appropriate controls, similar changes in kidney function and Na-K-Cl co-transport were observed. Offspring of hypertensive parents exhibit altered kidney function compared with their controls. Na-K-Cl co-transport in MHS rats is genetically determined and genetically associated with hypertension. In MHS rats the increase in Na-K-Cl co-transport seems to be linked to a cytoskeletal protein, adducin. In conclusion, a consistent sequence of events from a protein abnormality to cell and renal dysfunction may be proposed as being responsible for hypertension.