### 날짜 : 2024-03-21 15:37 ### 주제 : Hypertension induced by renal issues #medicine #공부 ---- Hypertension induced by renal issues primarily revolves around two main mechanisms: - the disruption of sodium and water balance, and - alterations in the renin-angiotensin-aldosterone system (RAAS). 1. **Disruption of Sodium and Water Balance**: The kidneys play a crucial role in regulating fluid and electrolyte balance. In conditions such as chronic kidney disease (CKD) or renal artery stenosis, the kidney's ability to excrete sodium is impaired, leading to sodium and water retention. This increased fluid volume elevates blood pressure. Furthermore, the kidneys' damaged nephrons may lead to increased sodium reabsorption, further exacerbating hypertension. 2. **Alterations in the Renin-Angiotensin-Aldosterone System (RAAS)**: The RAAS system plays a pivotal role in blood pressure regulation by adjusting arterial vasoconstriction and sodium retention. Renal impairment can lead to altered RAAS activity, where decreased renal perfusion stimulates excessive renin release. This increase in renin levels promotes the conversion of angiotensinogen to angiotensin I, and subsequently to angiotensin II, a potent vasoconstrictor. Angiotensin II not only increases blood pressure through vasoconstriction but also stimulates aldosterone secretion, leading to sodium and water retention, further increasing blood pressure. Additionally, kidney disease can lead to increased activity of the sympathetic nervous system and the production of endothelin, both of which can cause vasoconstriction and contribute to hypertension. > In the context of secondary hypertension, renal problems are among the most common causes. Recognizing and managing the underlying renal issues can often help control or significantly improve the hypertension. It's also important to consider the multifactorial aspects of renal-induced hypertension, as addressing these factors can lead to more effective management strategies.