9],, Meanwhile, hypertension and intraglomerular
high pressure due to VC, together with micro-VC in kidney, may accelerate the progress of CKD.
Perivascular epithelioid cell tumors (PEComas) of the kidney are a group of tumor family covering classical angiomyolipoma (AML), microscopic AML (microhamartoma), intraglomerular
lesions, cystic AML, epithelioid AML, oncocytoma-like AML and lymphangiomyomatosis of the renal sinus.
The increase in intraglomerular
pressure can damage the kidney structure and raise the risk of developing CKD in the long-term.
Smoking has been recognized as an independent risk factor for CKD, and smoking might result in intraglomerular
hypertension, vascular damage, or glomerulosclerosis via multiple complex interactions of nonhemodynamic (angiotensin II, transforming growth factor-[beta]1, endothelin-1) and hemodynamic factors (Orth and Hallan 2008).
They decrease systemic vascular resistance in congestive heart failure; enhance insulin sensitivity in Type 2 diabetes; enhance renal blood flow in renal insufficiency; enhance diminished intraglomerular
pressures in diabetic nephropathy, and enhance coronary blood flow in ischemic heart disease, thus, providing distinct benefits on concomitant conditions.
Another possible mechanism is the hemodynamic effect of ET-1, which in conjunction with other vasoactive factors lead to an increase in intraglomerular
capillary pressure which increases glomerular permeability and thus leads to increased filtration of proteins [18, 19].
ROS-induced activation of Ang II, a crucial component of RAS, is able to increase intraglomerular
pressure and activate the intracellular second messengers, which eventually results in the upregulation of urinary protein and renal fibrosis .
Entre las hipotesis que explicarian tal proteinuria se describe el aumento de la filtracion glomerular, la alteracion de la presion intraglomerular
con dano de la barrera glomerular y la reduccion de la reabsorcion tubular (7).
Both these groups of drugs reduce intraglomerular
pressure, lower systemic arterial BP, reduce proteinuria and, thus, delay the disease progression.
This study is of interest since hypertension, which increases intraglomerular
pressure and cause further progrssion of nephropathy, was similarly reduced with losartan administration.
Bowman's capsule dilatation and edema were noted without evidence of glomerular and/or epithelial cell damage in the proximal tubules (Fig.
However, from a physiological perspective, renin-angiotensin system (RAS) inhibitors cause a rise in creatinine owing to a reduction in intraglomerular
pressure--a 20% or less rise in creatinine is acceptable.