Renal vein renin measurements in normotensive children

Renal venous PRA was measured in 49 normotensive children without renal disease undergoing routine cardiac catheterization. PRA levels did not differ significantly between both renal veins and were significantly higher in the renal veins than in the IVC. There was a constant mean ratio of 1.21 between the renal veins and the IVC at low, intermediate, and high absolute PRA levels. Three patients had a renal venous PRA ratio greater than 1.4 and the highest ratio observed was 1.55. This fidning supports 1.5 as an acceptable upper limit of normality for the interpretation of renal vein PRA ratios in the investigation of patients with suspected renal hypertension. In four patients, PRA in the renal veins was significantly lower than in the IVC. The possibility of renin removal by these kidneys is discussed.