PETER WEIDMANN, M.D.; CARLO BERETTA-PICCOLI, M.D.; DAVID HIRSCH, M.D.; FRANCOIS C. REUBI, M.D.; SHAUL G. MASSRY, M.D., F.A.C.P.
Among eight patients with unilateral hydronephrosis and hypertension, peripheral plasma renin activity was normal in seven and borderline high in one. Four patients had hydronephrotic/contralateral kidney renin ratios of > 1.5, suggesting excessive renin release from the diseased kidney, and ratios between contralateral kidney and peripheral blood of < 1.2, indicating suppressed renin production in the contralateral kidney. Nephrectomy normalized blood pressure in each of these patients. Two patients had hydronephrotic/contralateral kidney renin ratios of ≤ 1.3 or contralateral kidney/periphery ratios of > 1.2, suggesting ischemia of the contralateral kidney; pyeloplasty or nephrectomy, or both, failed to improve the hypertension. Postoperative changes in blood pressure correlated with changes in peripheral renin (r = 0.90; P < 0.01). These data suggest that hypertension associated with unilateral hydronephrosis is partly renin-dependent; and renal vein renin values are helpful in selecting patients for surgery.
WEIDMANN P, BERETTA-PICCOLI C, HIRSCH D, REUBI FC, MASSRY SG. Curable Hypertension with Unilateral Hydronephrosis: Studies on the Role of Circulating Renin. Ann Intern Med. ;87:437–440. doi: 10.7326/0003-4819-87-4-437
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Published: Ann Intern Med. 1977;87(4):437-440.
Cardiology, Coronary Risk Factors, Hypertension, Nephrology.
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