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5/6th Nephrectomy in Combination with High Salt Diet and Nitric Oxide Synthase Inhibition to Induce Chronic Kidney Disease in the Lewis Rat
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5/6th Nephrectomy in Combination with High Salt Diet and Nitric Oxide Synthase Inhibition to Induce Chronic Kidney Disease in the Lewis Rat

Published on: July 3, 2013

Effects of nephrectomy on hypertension, renin activity and total renal function in patients with chronic renal artery

S Sonkodi1, G Abrahám, G Mohácsi

  • 1First Department of Internal Medicine, Albert Szent-Györgyi Medical University, Szeged, Hungary.

Journal of Human Hypertension
|June 1, 1990
PubMed

Insights

Nephrectomy improved hypertension and renal function in patients with renal artery occlusion. This surgery reduced high renin activity, suggesting a factor linked to the renin-angiotensin system depresses kidney function.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Renal Physiology

Background:

  • Hypertension is a significant risk factor for cardiovascular and renal disease.
  • Renal artery occlusion can lead to renovascular hypertension and impaired kidney function.
  • The renin-angiotensin system plays a crucial role in blood pressure regulation and renal perfusion.

Purpose of the Study:

  • To evaluate the impact of nephrectomy on blood pressure and renal function in patients with chronic total renal artery occlusion.
  • To investigate the role of plasma renin activity (PRA) and the renin-angiotensin system in the pathophysiology of renal artery occlusion-induced hypertension.

Main Methods:

  • Longitudinal observation of eight hypertensive patients with unilateral renal artery occlusion over ten years.
  • Pre- and post-operative measurements of blood pressure, peripheral plasma renin activity (PRA), serum creatinine, urine volume, and endogenous creatinine clearance.
  • Analysis of renal vein PRA ratio to assess renin production from the affected kidney.

Main Results:

  • All patients exhibited abnormally high peripheral PRA and renal vein PRA ratio (mean 3.18).
  • Nephrectomy in patients with small, affected kidneys (<9 cm) led to significant reductions in blood pressure (202/118 to 147/93 mmHg).
  • Post-nephrectomy, significant improvements were observed in peripheral PRA (P < 0.001), serum creatinine, urine volume, and creatinine clearance.

Conclusions:

  • Nephrectomy is an effective treatment for hypertension secondary to chronic unilateral renal artery occlusion.
  • The study suggests the presence of a renal function-depressing factor, possibly related to the renin-angiotensin system, in chronic renal artery occlusion.
  • Resolution of this factor post-nephrectomy contributes to improved blood pressure and renal function.

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