Is Microanatomy Destiny?

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Abstract
Dissecting the pathogenesis of primary, or “essential,” hypertension has proved elusive. In recent years, the hypothesis that having relatively fewer nephrons renders an otherwise healthy person more susceptible to renal disease, hypertension, or both has been supported by a substantive body of experimental data. However, data in humans have been largely circumstantial and indirect.In this issue of the Journal, Keller et al. (pages 101–108) present carefully derived evidence that bolsters this hypothesis. Kidneys from 10 persons who had died in accidents and who had had hypertension were compared with kidneys from 10 age-matched persons with normal blood pressure who . . .