[The function of the contralateral kidney in patients with nephrogenic arterial hypertension with unilateral...

The examination of 43 patients with unilateral lesions of the kidneys and their vessels was performed. The above condition was complicated by vasorenal (16 patients) or parenchymatous (27 patients) nephrogenic arterial hypertension. Mean arterial pressure (APm) was 143 +/- 12.4 mm Hg in mean duration of the disease 4.5 +/- 1.2 years. Mean age of the patients was 34.3 +/- 3.2 years. Dynamic renal scintigraphy determined glomerular filtration rate (GFR) using 99mTc-DTPA. Effective renal plasmic flow (ERPF) was measured with 131I-hippuran. 27 patients underwent acute captopril test with repeated renal scintigraphy. Angiography was used to evaluate plasma renin (PR) activity in renal veins. 1 year after various operations the patients were reexamined. By the value of diastolic pressure (DP), the above captopril test, changes in GFR and ERPF in the contralateral kidney and PR activity, the patients were divided into 3 groups. Group 1 of 13 patients had DP not higher than 90 mm Hg duration of the disease not more than 3 years. They responded to captopril test by AP decrease by 25-28%, PR activity increased 2.3 times. In the contralateral kidney GFR reduced by 7%, ERPF elevated by 15%. The renin coefficient reached 1.4-1.5. Group 2 of 22 patients had DP 95-100 mm Hg. They responded to captopril by APm 15% reduction, RP activity got 1.2-1.5 times higher, GFR in the contralateral kidney lowered by 10%, whereas ERPF rose by 10% Renin coefficient reached 1 or PR activity was higher in the contralateral kidney. Hypertension lasted in them 5 years. Group 3 patients (n = 8) had DP above 100 mg Hg.(ABSTRACT TRUNCATED AT 250 WORDS)