【高血压英文ppt课件】Hypertension and the Kidney.pptVIP

* 代理报关委托书委托报关协议关于审理城镇房屋租赁合同纠纷案件司法解释有关劳务派遣制度设计及对劳务派遣行业的影响分析糖皮质激素在呼吸系统疾病中的合理应用严重脓毒症导致急性肺损伤病人自发利尿现象的观察分析 * Hypertension and the Kidney Chong Myung Kang, M.D. Department of Internal Medicine Hanyang University Hospital Hypertension and the Kidney A. The Role of the Kidney in Hypertension B. Hypertension as a Cause of Renal Disease C. Hypertension as a Risk Factor for the Progression of Renal Disease D. Hypertension as a Consequence of Renal Disease Role of Kidney in Hypertension 1. Pressure-Volume Regulation 2. Congenital Oligonephropathy 3. Renal Transplantation Studies 4. Salt and Hypertension Pressure-natriuresis(1) Effect of elevated B.P. to raise Na excretion (Feedback system to stabilize B.P. body fluid volume) Long-term regulation of arterial pressure by adjusting blood volume Elevation of renal perfusion pressure(RPP) inc. Na exc. in the absence of change in RBF GFR (mediated by inhibition of tubular resorption) In hypertension ; resetting of pressure-natriuresis at higher blood pressure Fig. 1. Predicted long-term effects of a hypertensive stimulus, caused by increased total peripheral resistance, with no change in the renal pressure natriuresis mechanism. Blood pressure is initially elevated(from point A to point B), but hypertension cannot be sustained because sodium excretion exceed intake, thereby reducing extracellular fluid volume until blood pressure return to normal and intake and output of sodium are balanced Fig. 2. Predicted Long-term effects of a peripheral vasoconstrictor that has a relatively week effect on pressure natriuresis. The normal curve(Solid line) is compared with the vasoconstrictor curve(dash line). Initially, the vasoconstrictor would cause natriuresis, because increased peripheral vascular resistance elevates arterial pressure(from point A to point B) above the set-point for balance between intake and