Molecular Pathways in Hypertensive Renal Damage

Hypertension is a disease that increases adverse cardiovascular events and leads to end-organ damage. Kidney damage induced by hypertension depends on several factors. Contributing factors to hypertensive renal damage include renal and vascular structural components and hormonal and paracrine factors. Glomerular hypertension, low nephron number, and endothelial dysfunction are involved in the progression of chronic kidney disease associated with hypertension. The renin-angiotensin-aldosterone system, oxidative stress, and inflammation also contribute to glomerulosclerosis and tubulointerstitial fibrosis. Investigations continue to identify mechanisms and interactions between mechanisms that contribute to progression of kidney injury in hypertension. A full understanding of the complex interactions between renal vascular and structural components as well as hormonal and paracrine factors contributing to hypertension-induced chronic kidney disease will lead to better therapeutic strategies.