Is Primary Hypertension Associated With Inborn Reduced Number of Nephrons In The Majority of Cases?

Abstract

One of the numerous hypotheses, which can explain the etiopathogenesis of primary arterial hypertension, suggested that reduced number of nephrons, which was determined during fetal development is an important factor influencing blood pressure level in adult life. The results confirming this hypothesis were published recently.
It was demonstrated, that the member of nephrons in the kidneys of hypertensive persons (without kidney disease) was significantly lower than in matched normotensive persons. The mean glomerular volume in hypertensive persons was markedly greater than in normotensives. On the strength of these data, in this review the indirect evidence suggesting that inherited reduced nephron number may depend not only on environmental factors during fetal development (malnutrition) but also on the genetic factors is presented. A hypothesis was proposed that adaptative hypertrophy of less numerous nephrons is associated with the trait of sodium sensitivity of blood pressure. The results of the described studies may be of significant importance for clarification of the pathogenesis of primary arterial hypertension.