[Evaluation of the hypotensive effect and indications for the operation of nephropexy in patients with arterial hypertension combined with nephroptosis].
The results of the examination and nephropexy operation in 11 patients with arterial hypertension and nephroptosis are presented; a hypotensive effect was achieved in 5 of the operated patients; the follow-up period was up to 3 years. The recordings included the elevation of the arterial pressure in orthostasis, the changes in the urine sediment, the activity of plasma renin at rest and after 1-hour's orthostasis; excretory urography and the Seldinger abdominal aortography in a lying and upright position of the patient were conducted, as well as intraoperative biopsy of the renal tissue. Patients with a hypotensive effect exhibited a regular elevation of the arterial pressure in orthostasis, an increased plasma renin activity, congestive features in the descended kidney. The above symptoms permit to distinguish groups of patients with a hypotensive effect achieved after nephropexy, and those without effect. On the basis of the obtained results it was concluded that in some cases nephroptosis may be the cause of symptomatic arterial hypertension. In such cases it seems rational to recommend the nephropexy operation taking into account, when determining the indications for surgery, the degree of the orthostatic elevation of the arterial pressure and of the renin activity, and the symptoms of disorders in the renal evacuation function.
D000293:Adolescent; D000328:Adult; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging; D001027:Aortography; D001706:Biopsy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006977:Hypertension, Renal / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D007668:Kidney / Q000002:abnormalities* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011187:Posture; D012083:Renin / Q000097:blood; D014567:Urography
D012083:Renin
Otsenka gipotenzivnogo éffekta i pokazaniia k operatsii nefropeksii u bol'nykh arterial'noĭ gipertonieĭ v sochetanii s nefroptozom