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Relationship between collateral development and renin in experimental renal arterial stenosis
Surgery
|August 1, 1976
Summary
Renal venous plasma renin activity (RVPRA) ratios can predict renovascular hypertension treatment success. Non-lateralizing ratios may mislead, but collateral circulation can restore RVPRA ratios toward normal.
Area of Science:
- Nephrology
- Vascular Surgery
- Hypertension Research
Background:
- Lateralizing renal venous plasma renin activity (RVPRA) ratios are crucial for predicting revascularization success in renovascular hypertension.
- Non-lateralizing renin ratios may incorrectly suggest a lack of functional significance in renal arterial stenosis, potentially denying patients beneficial surgical interventions.
Purpose of the Study:
- To investigate if RVPRA ratios normalize with the development of collateral circulation in ischemic kidneys.
- To test the hypothesis that collateral development leads to RVPRA ratios approaching unity.
Main Methods:
- Gradual unilateral renal arterial occlusion was induced in nine dogs over 10 weeks.
- Measurements included arterial blood pressure, arteriographic collateral channels, RVPRA, and renal surface index (RSI) to assess renal blood flow.
- Data were collected before and during the occlusion period.
Main Results:
- Arterial pressure increased, and collateral vessel formation to the constricted kidney was observed over time.
- Initially, renal surface index (RSI) ratios decreased, and RVPRA ratios increased.
- Subsequently, as collateral circulation developed, RSI ratios increased, and RVPRA ratios decreased towards baseline.
Conclusions:
- The development of collateral circulation can cause RVPRA ratios to revert towards unity.
- Absence of lateralizing RVPRA ratios in the presence of collateral vessels does not rule out the functional significance of renal arterial stenosis.