Hypertensive nephropathy risk factors
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aarti Narayan, M.B.B.S [2]Nasrin Nikravangolsefid, MD-MPH [3]
Risk Factors
- High systolic blood pressure is a very strong risk factor for the development of hypertensive nephrosclerosis.
- African Americans are more likely to develop hypertensive nephropathy. Firstly, a number of causes had been suggested:
- Higher prevalence and severity of hypertension
- Lower socioeconomic status
- Poor healthcare accessibility.
- However, Ethnic differences related to hypertensive nephropathy remained after adjusting age, sex, and prevalence of hypertension among ethnic groups, suggesting the presence of genetic predisposition in this population.[1]
- Genetic susceptibility
- Non-muscle myosin heavy chain 9 gene (MYH9), which regulates the function of podocyte cytoskeleton, is associated with hypertensive ESRD in African Americans.[2]
- Solidified glomerulosclerosis secondary to hypertension in African American is associated with apolipoprotein L1 gene (APOL1)[3]
- Chromogranin A gene variants, which block secretion of catecholamine, is also contributed to hypertensive ESRD in African Americans.[4]
- The Framingham heart study showed that a combination of hypertension with a mild reduction in glomerular filtration rate increases the risk of developing chronic renal failure.
- Diabetes, smoking, obesity and high levels of low density lipoproteins also accelerates the progression of renal damage secondary to hypertension.
References
- ↑ Murea, Mariana; Freedman, Barry I (2010). "Essential hypertension and risk of nephropathy: a reappraisal". Current Opinion in Nephrology and Hypertension. 19 (3): 235–241. doi:10.1097/MNH.0b013e3283366344. ISSN 1062-4821.
- ↑ Kopp, Jeffrey B; Smith, Michael W; Nelson, George W; Johnson, Randall C; Freedman, Barry I; Bowden, Donald W; Oleksyk, Taras; McKenzie, Louise M; Kajiyama, Hiroshi; Ahuja, Tejinder S; Berns, Jeffrey S; Briggs, William; Cho, Monique E; Dart, Richard A; Kimmel, Paul L; Korbet, Stephen M; Michel, Donna M; Mokrzycki, Michele H; Schelling, Jeffrey R; Simon, Eric; Trachtman, Howard; Vlahov, David; Winkler, Cheryl A (2008). "MYH9 is a major-effect risk gene for focal segmental glomerulosclerosis". Nature Genetics. 40 (10): 1175–1184. doi:10.1038/ng.226. ISSN 1061-4036.
- ↑ Robinson, Todd W.; Freedman, Barry I. (2019). "The Impact of APOL1 on Chronic Kidney Disease and Hypertension". Advances in Chronic Kidney Disease. 26 (2): 131–136. doi:10.1053/j.ackd.2019.01.003. ISSN 1548-5595.
- ↑ Salem, Rany M.; Cadman, Peter E.; Chen, Yuqing; Rao, Fangwen; Wen, Gen; Hamilton, Bruce A.; Rana, Brinda K.; Smith, Douglas W.; Stridsberg, Mats; Ward, Harry J.; Mahata, Manjula; Mahata, Sushil K.; Bowden, Donald W.; Hicks, Pamela J.; Freedman, Barry I.; Schork, Nicholas J.; O'Connor, Daniel T. (2008). "Chromogranin A Polymorphisms Are Associated With Hypertensive Renal Disease". Journal of the American Society of Nephrology. 19 (3): 600–614. doi:10.1681/ASN.2007070754. ISSN 1046-6673.