Renin-producing renal cell carcinomas--clinical and experimental investigations on a special form of renal hypertension.
The pathogenetic relationship between tumour and hypertension was investigated in 129 patients with renal cell carcinoma, of whom 41 (31.8%) were hypertensive. Of these 41 patients with renal tumours and hypertension, 6 (14.6%) were found to have primary reninism. In these patients the plasma renin activity in blood from the renal veins showed a tumour kidney to contralateral kidney ratio of between 4 and 7, and 2 patients also had secondary hyperaldosteronism. In the same 6 cases the renin content in the renal tumour tissue was significantly higher than that in tissue from the adjacent tumour-free renal cortex of the ipsilateral kidney. Immunohistochemical demonstration of renin in the tumour was only possible in these 6 cases. In 5 of these patients blood pressure returned to normal following nephrectomy; in the 6th case there was a drop in blood pressure after nephrectomy. In 3 renin-positive tumours examined, autonomous renin production was demonstrated in cell culture. Renin-producing renal cell carcinomas are an uncommon cause of renal hypertension. The differential diagnosis of hypertension should therefore also include renal tumour.
Steffens
J
J
Department of Urology, University of Saarland, Homburg/Saar, FRG.
Bock
R
R
Braedel
H U
HU
Isenberg
E
E
Bührle
C P
CP
Ziegler
M
M
D002216:Captopril; D002292:Carcinoma, Renal Cell / Q000150:complications* / Q000201:enzymology; D006801:Humans; D006929:Hyperaldosteronism / Q000209:etiology; D006977:Hypertension, Renal / Q000209:etiology*; D007668:Kidney / Q000201:enzymology*; D007680:Kidney Neoplasms / Q000150:complications* / Q000201:enzymology; D011863:Radioimmunoassay; D012083:Renin / Q000096:biosynthesis* / Q000097:blood; D014407:Tumor Cells, Cultured / Q000201:enzymology
D002216:Captopril; D012083:Renin