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ACE INHIBITORS AND RENAL DISEASE: THE GOOD, BAD, AND UGLY

机译:ACE抑制剂和肾病:好,坏,丑陋

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By altering pre-glomerular resistance, healthy kidneys can maintain relatively stable glomerular capillary pressures despite variations in systemic blood pressure. This pressure regulatory process is termed "renal autoregulation". Autoregulation can be reduced when renal disease results in loss of nephrons. Compromised autoregulation allows high systemic blood pressure to be transmitted to glomerular capillaries. This glomerular hypertension has been documented by micropuncture studies in dogs and cats with surgically reduced renal mass. In these models, glomerular hypertension was associated with glomerular hypertrophy, sclerosis and proteinuria. Systemic hypertension is relatively common in dogs and cats with renal disease. In a recent study of dogs with spontaneous chronic kidney disease (CKD), 29/45 (64%) had systolic blood pressure > 144 mm Hg and 14/45 (31%) had systolic blood pressure > 161 mm Hg. In cats with naturally-occurring CKD, systemic hypertension has been observed in 19-65% of cases depending on the definition of hypertension.
机译:尽管系统血压变化,但通过改变预肾小球抗性,健康的肾脏可以保持相对稳定的肾小球压力。该压力调节过程称为“肾自动调节”。当肾病导致肾脏损失时,可以减少自疗。受损自动调节允许将高系统血压传递给肾小球毛细管。这种肾小球高血压已经通过微直流研究在狗和猫的微直流研究中记载,具有手术减少的肾肿块。在这些模型中,肾小球高血压与肾小球肥大,硬化症和蛋白尿有关。系统性高血压在患有肾病和肾病的猫类中相对常见。在最近对具有自发慢性肾病(CKD)的狗的研究中,29/45(64%)的收缩压> 144mm Hg和14/45(31%)具有收缩压> 161mm Hg。在具有天然存在的CKD的猫中,根据高血压定义,19-65%的病例中观察到全身高血压。

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