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Abstract
Experimental studies have suggested that glomerular hypertension is ultimately damaging
to the kidney. Prevention of glomerular hypertension by dietary protein restriction
or antihypertensive therapy lessens glomerular injury in several experimental models
of chronic renal disease. Glomerular hypertension and hyperfiltration also occur in
humans with diabetes mellitus, solitary or remnant kidneys, and various forms of acquired
renal disease. Clinical studies are beginning to show that dietary protein restriction
and antihypertensive therapy may slow progression in these disorders. Large multicenter
trials are currently under way to better define the effects of these therapeutic maneuvers
on the progression of chronic renal disease.