高血压与肾病ppt课件_1.ppt

;Epidemiology ofRenal Disease inHypertension;Renal Disease in HypertensionEpidemiology;Renal Disease in HypertensionA Historical Perspective;Risk Factors for Progression of Renal Disease;ESRD Due to Any CauseIn 332,544 Men Screened for MRFITAdjusted Relative Risk§;HTN Linked To Chronic Renal Disease Among 332,544 Men Screened for MRFIT;Incidence Rates of Reported ESRD by Primary Diagnosis;Diabetes 50%;Persons Initiating Treatment for ESRD Related to Diabetes in the US;Amos A, McCarty D, Zimmet P. Diabetes Medicine. 1997;14[Suppl5]:S1-85. ;* p 0.0001;Effect of Hypertension on Mortality in Diabetic Pima IndiansAge-Adjusted Death Rates for Diabetic Nephropathy ;Risk of Ischemic Heart Disease Related to SBP and Microalbuminuria;Microalbuminuria Compared To Traditional Risk Factors For Ischemic Heart Disease;;Comorbidities in Renal Disease Patients (1999);Crude Incidence Rates of Reported End Stage Renal Disease;Racial Distribution for Comorbidities In Dialysis Patients (1999);CV Mortality in General Population (GP) Dialysis Patients, By Race ;Hypertension and Chronic Renal Disease: Hemodynamic Abnormalities;Prevalence of HypertensionIn Chronic Renal Diseases;Hypertension and Renal Disease:Mechanisms;Glomerulus;Glomerular hypertension Hyperfiltration Glomerular barrier dysfunction Proteinuria Mesangial cell hyperplasia Intrarenal inflammatory processes Endothelial dysfunction VSMC proliferation;Functional Decrease in GFR Proteinuria Structural Glomular basement membrane changes Expanded mesangial matrix Glomerulosclerosis Tubulo-interstitial fibrosis;Effects of Vasodilators in the Normal Kidney;Imbalance in Factors Affecting Vascular Tone and Structure;+ ;Renin-Angiotensin Cascade;Angiotensin II (Ang II) generated in the afferent arteriole interacts with AT1 receptors on cellular components of the nephron;Role of Angiotensin II in Chronic Renal Disease;Angiotensin II Induces Oxidative Stress in the Kidney; O2 H2O2