Protective Importance of the Myogenic Response in the Renal Circulation

Primary essential hypertension is second only to diabeticnephropathy as a etiology for end-stage renal disease.1 In addition, coexistent/superimposed hypertension plays a major role in the progression of most forms of chronic kidney disease (CKD), including diabetic nephropathy.2–5 Neverthe-less, the individual risk is very low, with 1 % of the hypertensive population developing end-stage renal disease. Such data indicate that there must be mechanisms that normally protect the kidneys from hypertensive injury of a severity sufficient to result in end-stage renal disease. The following Brief Review summarizes the evidence that indi-cates that the renal autoregulatory response, primarily medi-ated by the myogenic mechanism, is largely responsible for such protection. Moreover, the differing patterns of renal damage that are observed in clinical and experimental hyper-tension are best explained when considered in the context of