Blood pressure and renal function

Abstract

The relationship between blood pressure (BP) and renal function was studied in samples of 49-year-old men. Of 3 205 49-year-old men, 2 376 (74%) took part in a BP screening. By systematic sampling, based on diastolic BP levels varying from very low to very high, 120 subjects were selected for this study. Only subjects who were not on antihypertensive treatment were included. Renal blood flow (RBF), renovascular resistance (RVR), glomerular filtration rate (GFR), filtration fraction (FF) and renal concentrating capacity were studied in 111 subjects, none of whom had advanced hypertension. With increasing BP there was a decrease in RBF (r = -0.34) and an increase in RVR (r = 0.81) and FF (r = 0.35). The changes in renal haemodynamics occurred gradually from low to high BP, and did not start at any particular BP level. With increasing BP, GFR was unchanged. An "autoregulation of GFR" was thus found at all BP levels studied. Renal concentrating capacity was unchanged. These findings indicate that renal haemodynamics in essential hypertension are adjusted mainly to ensure a constant GFR.