Hypertension and the Kidney

The kidney is important not only in the genesis of blood pressure elevation, but declining renal function is also important for predicting cardiovascular risk. The primacy of the kidney in causing essential hypertension was a topic of debate until the proof-of-principle experiment was performed, which demonstrated remission of essential hypertension in six African-American hypertensives with ESRD after they received successful kidney transplants from normotensive donors. The resolution of hypertension and hypokalemia in a patient with Liddle's syndrome and ESRD after subsequent successful renal transplantation also demonstrated the primacy of the kidney in a monogenic form of hypertension related to sodium epithelial channel dysfunction.