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Abstract
Experimental studies incriminate glomerular hypertension in mediating progressive
renal damage after any of a variety of initiating injuries. Prevention of glomerular
hypertension by dietary protein restriction or antihypertensive therapy lessens progressive
glomerular damage 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
indicate that dietary protein restriction and antihypertensive therapy also slow progression
in many of these disorders. Large multicenter trials confirm the beneficial effects
of these therapeutic maneuvers on the rate of progression of chronic renal disease.