Evaluation of Pressor Assay, Plasma Renin Activity, and Aldosterone Excretion in Renal Vascular Hypertension

摘要

Hypertension resulting from compromised renal arterial perfusion or focal parenchymal renal disease continues to be a diagnostic problem. A simple inexpensive test to screen these patients from the general hypertensive population is needed. Of major importance is the ability to determine those patients whose hypertension will respond favorably to surgery. Although differences in split renal excretory function have been useful, false positive and negative tests occur. The purposes of this study were to evaluate renin activity and aldosterone excretion in the diagnosis and surgical cure of renal vascular hypertension and to correlate them with the assay of pressor substance of renal venous plasma. Peripheral venous renin activity was elevated in three-fourths of the patients when measured in supine and upright postures. An increased excretion of aldosterone was less common; it was seen in only five patients, including four with high elevations of peripheral renin. A difference in renal vein renin activity was useful in predicting a response to surgery. Six of the eight patients who had successful surgical correction had bilateral renal renin studies; five of them had a twofold increase in renal vein renin activity from the diseased kidney compared to the normal kidney. One patient with normal renin studies also responded to surgery. The pressor assay had a direct relationship with the elevation of renin activity in renal and peripheral venous blood, but was less informative than the renin assay. (Author)