Controversy regarding the wisdom of a high salt intake has been with us for 5000 years. In the Nei Ching, the oldest of the extant medical writings, the Yellow Emperor observed, "Hence, if too much salt is in the food, the pulse hardens, tears make their appearance, and the complexion changes". At about the same period in history, Job asked the question, "Can that which is unsavory be eaten without salt?" It is not apparent whether or not the Almighty provided a clear answer. The connection between dietary salt intake and hypertension was appreciated following the observations of AMBARD, BEAUJARD, VOLLHARD, ALLEN, and others. However, DAHL emphasized this relationship, as demonstrated by his epidemiological observations, his studies in human subjects, and his development of a genetically mediated form of salt-sensitive hypertension in rats. DAHL and his followers argued that hypertension was a disease of acculturation, or even of self-abuse. Undaunted by skeptics such as PICKERING, they suggested that if Western man would merely curtail his intake of the granular condiment, hypertension would not develop and blood pressure would not increase with age. Bucolic native societies were given as examples where such cardiovascular bliss was readily attained.

The First International Symposium on Mechanism and Treatment in Essential Hypertension was held on October 23 and 24, 1985 in Nagoya. The Second International Symposium, which was held on May 30,31, and June 1, 1988 in Nagoya, was a success thanks to the endeavors of all the participants. These symposiums were made possible by the generous support of the city of Nagoya, Aichi Prefec ture, and various contributions. Understanding of the mechanisms of gene (major gene, essential) hypertension is impossible unless we comprehend the physiological properties of arterial smooth muscle. Since Langendorff's discovery of the role of calcium ions in muscle contraction in 1895, we have made immense progress in our knowledge of the role of the calcium ion in the excitation-contraction coupling of the arterial smooth mus cle. Investigation of the molecular mechanisms controlling the cellu lar basis of calcium ion action has been established with the discovery of the calcium binding protein (Ebashi 1963). The participation of the calcium induced calcium mechanism in the contraction of muscle has been directly demonstrated by using chemically skinned smooth muscle fibers (Endo et al. 1977). Methods for intracellular free cal cium contents and calcium channel activity have been developed and contribute to the study of the role of the calcium ion in arterial smooth muscle contractility. Such recent progress promotes study of the basic physiological, biochemical, and molecular properties of the calcium channel, and, in the field of hypertension research, the sodium and potassium channels.

A few years ago, as the editor of Kidney International, I was ap proached by Drs. Cohen, Kassirer, and Harrington who suggested that a new feature should be included in each monthly issue of the journal. They suggested that it should employ a case discussion format such as that used frequently at specialty rounds in teaching hospitals, and that the discussion should place a special emphasis on the relationship between basic science and important problems in clinical nephrology. The summary of an actual patient history would first be presented to exemplify a particular clinical problem, a seasoned person of proven expertise would be invited to deliver a well-documented analysis of the relevant issues, and perhaps most ambitiously of all, a critical audience would be assembled to challenge the principal discussant in an open ended, question-and-answer period. The entire affair would be recorded at the time of the live conference and transcribed subse quently in preparation for publication as a "Nephrology Forum. " I must confess that I was somewhat hesitant at first to endorse their proposal because, at the time, Kidney International had just begun to establish a solid reputation for the publication of high quality, peer reviewed manuscripts dealing with the clinical and laboratory research interests of the international nephrological community.

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Conditions such as oxidative stress and hypoxia, which have a generalized impact on the oxygen metabolism, have been implicated in the genesis of kidney disease. This means that deepening our understanding of the pathobiology of oxygen metabolism in such diseases could be a fruitful path towards tangible clinical benefits. Studies in Renal Disorder collects reviews from leading researchers and clinical scientists working in exactly this field, providing an overview of the latest advances. The causal role of impaired oxygen metabolism in kidney disease has numerous clinical implications. It affects our understanding of the therapeutic benefits accruing from anti-hypertensive agents; the way we control hyperglycemia/hyperinsulinemia and hyperlipidemia; and our use of dietary approaches to the correction of obesity. The defensive mechanisms against oxidative stress, such as the Nrf2-Keap1 system, and hypoxia, such as the PHD-HIF system, have recently been explored in various cells, including kidney cells. These mechanisms include intracellular sensors for oxidative stress and hypoxia. This means that novel approaches targeting these sensors may offer clinical benefits in kidney disease in which oxidative stress and/or hypoxia is a final, common pathway.

Edited by a renowned scientist in the field with more than 200 high profile scientific publications to his name, this is the first book to provide a comprehensive overview of all cardiovascular hormone systems. Clearly structured, the text covers steroid and peptide hormones, amines, and arachidonic acid metabolites, as well as such others as nucleotides, nitric oxide, and acetylcholine. An essential reference for researchers working on the cardiovascular system and related diseases.