The Kidney as a Determinant of Genetic Hypertension

S everal lines of evidence suggest that the kidney plays an important role in the genesis of primary hypertension in humans and genetic hypertension in animals. Perhaps the most compelling evidence derives from clinical 1-4 and experimental renal transplantation studies, which have been performed over the last 3 decades. In v rtually all of these studies, the genetic background of the donor kidney had a major impact on long-term blood pressure in the recipients. More specifically, renal grafts from genetically hypertensive donors increased blood pressure in genetically normotensive recipients, whereas renal grafts from genetically normotensive donors lowered blood pressure in genetically hypertensive recipients. In many but not all of the studies, blood pressure traveled with the kidney in both directions.