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Tubulointerstitial disease: Role of ischemia and microvascular disease

Title
Tubulointerstitial disease: Role of ischemia and microvascular disease
Authors
Nakagawa T.Kang D.-H.Ohashi R.Suga S.-I.Herrera-Acosta J.Rodriguez-Iturbe B.Johnson R.J.
Ewha Authors
강덕희
SCOPUS Author ID
강덕희scopus
Issue Date
2003
Journal Title
Current Opinion in Nephrology and Hypertension
ISSN
1062-4821JCR Link
Citation
vol. 12, no. 3, pp. 233 - 241
Indexed
SCI; SCIE; SCOPUS WOS scopus
Abstract
Purpose of review: Tubulointerstitial injury is characteristic of aging-associated renal injury and progressive renal disease. Salt-sensitive hypertension is also associated with tubulointerstitial inflammation, especially when accompanied by microvascular disease. Here we summarize recent studies on the pathogenesis and consequences of tuburointerstitial disease, emphasizing the role of ischemia and the microvasculature. Recent findings Tuburointerstitial injury occurs via several mechanisms of which one of the most important is chronic ischemia. Recent studies suggest that chronic vasoconstriction may contribute to the renal injury associated with angiotensin II, catecholamines, nitric oxide inhibition, hypokaremia, hyperuricemia, and cyclosporine nephropathy. Salt-sensitivity may result as a consequence of the tubulointerstitial inflammatory response to these conditions, and this appears to be perpetuated by the development of preglomerular vascular disease. With progression of tuburointerstitial disease there is also a loss of peritubular capillaries, and stimulating microvascular growth with angiogenic factors can stabilize renal function in these models. Summary: Ischemia secondary to vasoconstriction or to structural changes of the renal vasculature may have important consequences both in terms of mediating salt-sensitive hypertension and renal progression. Angiogenic factors may have potential benefit in preventing or treating these conditions. © 2003 Lippincott Williams & Wilkins.
DOI
10.1097/00041552-200305000-00003
Appears in Collections:
의과대학 > 의학과 > Journal papers
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