ReviewHypertension research : official journal of the Japanese Society of Hypertension2024
Heterogeneous afferent arteriolopathy: a key concept for understanding blood pressure-dependent renal damage.
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.
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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.
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Who cites it
16 citing papers in PubMed.
- Pathophysiology and Clinical Relevance of Microvascular Remodeling in Arterial Hypertension.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2026Review
- A Dynamic Online Nomogram for Predicting Postoperative Acute Kidney Injury After Sleeve Gastrectomy.Medical science monitor : international medical journal of experimental and clinical research · 2026Article
- Review
- Synergistic effect of obesity on hypertensive renal arteriosclerosis in individuals without chronic kidney disease: A zero-hour biopsy-based cohort study.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- 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 · 2026Review
- Long nighttime sleep duration and risk of renal tubular damage: evidence from rural China and a Mendelian randomization analysis.Renal failure · 2025Observational
- Reply to a letter to the editor regarding "Heterogeneous afferent arteriolopathy: a key concept for understanding blood pressure-dependent renal damage".Hypertension research : official journal of the Japanese Society of Hypertension · 2025Article
- Morphometric perspective supporting the concept of heterogeneous afferent arteriolopathy in hypertensive nephrosclerosis.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Article
- Non-Ser36 phosphorylated p66Shc inhibits TRPC-dependent and TRPC-independent calcium influx in vascular smooth muscle cells.Biochemical and biophysical research communications · 2025Article
- Development and Validation of a Predictive Model for Severe Tubular Atrophy/Interstitial Fibrosis in Patients with IgA Nephropathy: Multicenter Retrospective Study.JMIR medical informatics · 2025Article
- Nicotinism vs. Glomerulopathies-Smoking as a Risk Factor for Primary Glomerulopathies.Antioxidants (Basel, Switzerland) · 2025Review
- Histopathology of Diabetic Nephropathy: Beyond Glomerular Basement Membrane Thickening.Cureus · 2025Review
- Hypertensive Nephrosclerosis: Pathological Changes and Overlap with Diabetic Nephropathy.Cureus · 2025Review
- 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 · 2025Article
- G-Protein-Coupled Receptors in Chronic Kidney Disease Induced by Hypertension and Diabetes.Cells · 2025Review
- Educational Case: Diabetic nephropathy.Academic pathologyArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
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.
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