Evidence mapPaperPMID 39379463Full record

ReviewHypertension research : official journal of the Japanese Society of Hypertension2024

Heterogeneous afferent arteriolopathy: a key concept for understanding blood pressure-dependent renal damage.

Kentaro Kohagura, Ryo Zamami, Nanako Oshiro, Yuki Shinzato, Noriko Uesugi

Abstract readReview
In one paragraph

Review in Hypertension research : official journal of the Japanese Society of Hypertension, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed.

  1. Pathophysiology and Clinical Relevance of Microvascular Remodeling in Arterial Hypertension.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2026
    Review
  2. A Dynamic Online Nomogram for Predicting Postoperative Acute Kidney Injury After Sleeve Gastrectomy.Medical science monitor : international medical journal of experimental and clinical research · 2026
    Article
  3. Review
  4. Article
  5. Why are SGLT2 inhibitors effective in HFpEF? Implications for interstitial fluid retention and cardio-renal interaction.Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Review
  6. Observational
  7. Article
  8. Morphometric perspective supporting the concept of heterogeneous afferent arteriolopathy in hypertensive nephrosclerosis.Hypertension research : official journal of the Japanese Society of Hypertension · 2025
    Article
  9. Article
  10. Article
  11. Review
  12. Review
  13. Review
  14. Role of time in target range in blood pressure management for preventing renal decline in type 2 diabetes.Hypertension research : official journal of the Japanese Society of Hypertension · 2025
    Article
  15. Review
  16. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Kentaro KohaguraDialysis Unit, University of the Ryukyus Hospital, Okinawa, Japan. kohagura@med.u-ryukyu.ac.jp.
Ryo ZamamiDepartment of Cardiovascular Medicine, Nephrology and Neurology Faculty of Medicine, University of the Ryukyus, Okinawa, Japan.
Nanako OshiroDialysis Unit, University of the Ryukyus Hospital, Okinawa, Japan.
Yuki ShinzatoDepartment of Cardiovascular Medicine, Nephrology and Neurology Faculty of Medicine, University of the Ryukyus, Okinawa, Japan.
Noriko UesugiDepartment of Pathology, Fukuoka University School of Medicine, Fukuoka, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Hypertension, aging, and other factors are associated with arteriosclerosis and arteriolosclerosis, primary morphological features of nephrosclerosis. Although such pathological changes are not invariably linked with renal decline but are prevalent across chronic kidney disease (CKD), understanding kidney damage progression is more pragmatic than precisely diagnosing nephrosclerosis itself. Hyalinosis and medial thickening of the afferent arteriole, along with intimal thickening of small arteries, can disrupt the autoregulatory system, jeopardizing glomerular perfusion pressure given systemic blood pressure (BP) fluctuations. Consequently, such vascular lesions cause glomerular damage by inducing glomerular hypertension and ischemia at the single nephron level. Thus, the interaction between systemic BP and afferent arteriolopathy markedly influences BP-dependent renal damage progression in nephrosclerosis. Both dilated and narrowed types of afferent arteriolopathy coexist throughout the kidney, with varying proportions among patients. Therefore, optimizing antihypertensive therapy to target either glomerular hypertension or ischemia is imperative. In recent years, clinical trials have indicated that combining renin-angiotensin system inhibitors (RASis) and sodium-glucose transporter 2 inhibitors (SGLT2is) is superior to using RASis alone in slowing renal function decline, despite comparable reductions in albuminuria. The superior efficacy of SGLT2is may arise from their beneficial effects on both glomerular hypertension and renal ischemia. A comprehensive understanding of the interaction between systemic BP and heterogeneous afferent arteriolopathy is pivotal for optimizing therapy and mitigating renal decline in patients with CKD of any etiology. Therefore, in this comprehensive review, we explore the role of afferent arteriolopathy in BP-dependent renal damage.

Indexed as

Blood PressureAnimalsAntihypertensive AgentsArteriolesHumansHypertensionKidneyNephrosclerosisRenal Insufficiency, ChronicAntihypertensive AgentsAntihypertensive therapyGlomerular hypertensionHeterogeneous afferent arteriolopathyNephrosclerosisRenal ischemia

Identifiers

PMID39379463
PMCPMC11618077

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.