RENAL-FUNCTION IN PRIMARY HYPERTENSION

Studies of kidney cross-transplantation in the Milan hypertensive stra in of rats (MHS) and in its control strain (MNS) have demonstrated tha t the kidney has a causal role in the development of hypertension in t his animal model. The same result was obtained in two other strains of rats with genetic hypertension. Patients receiving a kidney from a do nor with hypertensive parents require more antihypertensive therapy th an recipients of a kidney from a donor with a normotensive family. Whe n MHS rats and a subset of patients with primary hypertension were com pared with their appropriate controls, similar changes in kidney funct ion 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 genetic ally associated with hypertension. In MHS rats the increase in Na-K-Cl co-transport seems to be linked to a cytoskeletal protein, adducin. I n conclusion, a consistent sequence of events from a protein abnormali ty to cell and renal dysfunction may be proposed as being responsible for hypertension.