Hypertension and unilateral parenchymal renal disease. Evidence for abnormal vasoconstriction-volume interaction.
Hypertension was not renin-dependent in the majority of 62 hypertensive patients with seemingly unilateral renal parenchymal disease, as indicated by plasma renin activity: low in 14 (23%), normal in 40 (56%), and high in only 8 (13%). By a weighted scoring system for analysis of differential renal-vein and peripheral renin levels, 70% (16 of 23) of these patients did not give scores predictive of cure by nephrectomy. Thus, occult bilateral disease reflected by attendant volume expansion and consequent reactive renin suppression may explain the well-known disappointing cure rate after uninephrectomy in this group. Since unilateral hypersecretion of renin with a completely normal contralateral kidney is rare in this group, abnormal renal-vein and peripheral renin values should be a prerequisite for advising nephrectomy, especially when the suspected kidney shows considerable excretory function.
D000293:Adolescent; D000328:Adult; D001794:Blood Pressure; D001810:Blood Volume; D002648:Child; D003250:Constriction; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000503:physiopathology / Q000601:surgery; D006977:Hypertension, Renal / Q000503:physiopathology*; D007668:Kidney / Q000378:metabolism; D007674:Kidney Diseases / Q000097:blood* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D012083:Renin / Q000378:metabolism*; D014666:Vasomotor System
D012083:Renin