Clinic of Nephrology, Faculty of Medicine, University of Belgrade , Belgrade , Serbia
Whether hypertension is the cause or effect of kidney disease is the long lasting question which has to
be discussed in future. Together these two diseases have become epidemics in present society and are
associated with the increased risk of cardiovascular diseases. Over the last several decades multiple
clinical, experimental and genetic studies have shown the kidney to be an important determinant of the
essential hypertension. However, little is known about the direct mechanisms by which the kidney induces
hypertension or why the blood pressure tends to rise in patients with chronic kidney disease. This paper
described pathophysiology of the essential hypertension and its relationship to chronic kidney disease
and cardiovascular disease. Particular focus has been drawn to effects of the renal sodium handling,
renin angiotensin aldosterone system, the sympathetic system, as well as mediators of the vascular tone
in development of kidney-induced hypertension. In addition, the mediators initiating and maintaining
the progression of chronic kidney disease and the interrelation of these factors and development of
hypertension have been discussed.
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