Peripheral renal vascular disease in essential hypertension: hemodynamic, angiographic, and endocrine assessment

Renal hemodynamic (133Xe-washout) and angiographic studies were performed in 46 patients with essential hypertension to demonstrate a possible correlation between graded renal small vessel disease and changes in renal blood flow. In addition, influence of the effects of duration of hypertension, diastolic blood pressure values and renal vein renin activity on hemodynamic and arteriographic findings were evaluated. Our results demonstrate that in patients with accelerated or severe renal small vessel disease the mean and cortical renal blood flow is significantly reduced (P less than 0.001). Furthermore, renal arteriosclerosis becomes evident in patients with long-standing hypertension, high diastolic blood pressure values, and elevated renal vein renin levels. Correlations between renal blood flow and renal vein renin activity (r = 0.45) apparently are governed by severity of the renal arteriosclerosis.