Mazo E B, Akopian A S, Iankovoĭ A G, Koriakin M V
Urol Nefrol (Mosk). 1990 May-Jun(3):23-30.
Analysis of examination and treatment of 104 patients who were periodically exposed to hemodialysis and 60 persons who sustained the allotransplantation of a cadaveric kidney enabled the authors to reveal the incidence of arterial hypertension before and after the transplantation. Pronounced arterial hypertension (AH) was documented in patients who were treated with hemodialysis sessions for the proper renal diseases developed in angionephrosclerosis (chronic glomerulo- and pyelonephritis). In those who sustained the transplantation, AH was pronounced in case of acute of chronic rejection, transplanted artery stenosis of renal renin hyperproduction. Higher incidence of AH (2.3-fold higher) was observed in posttransplantation patients with the native kidney left. It correlated with higher peripheral plasma renin activity (RRA). The authors suggested that the scheme should be used for the diagnosis of AH manifestation both before and after the transplantation which included the account for the cause of the disease terminal stage, the character of the AH variance in hemodialysis captopril testing, radiocardiographic examination, indirect renal angiography (99-Tc pertechnetate) or selective blood testing for RPA in case bilateral nephrectomy should be made in two stages. For the patients who had sustained the transplantation of the kidney, the diagnostic scheme should include a double pulse Doppler sonography, arteriographic investigation of the transplant and pharmacorenography with a captopril load test. Advisability of captopril stimulation of renin secretion during the selective sampling of the blood was demonstrated. The authors verified the time-course of renin activity, the concentration of aldosterone, cortisol and adrenocorticotrophic hormone in patients with a history of bilateral nephrectomy, defined the indications for bilateral nephrectomy associated with AH and discussed its possible outcomes.(ABSTRACT TRUNCATED AT 250 WORDS)
对104例定期接受血液透析的患者以及60例接受尸体肾同种移植的患者进行检查和治疗分析后，作者得以揭示移植前后动脉高血压的发病率。在因血管性肾硬化（慢性肾小球肾炎和肾盂肾炎）导致的适当肾脏疾病而接受血液透析治疗的患者中，记录到明显的动脉高血压（AH）。在接受移植的患者中，急性或慢性排斥反应、移植肾动脉狭窄或肾素过度分泌时会出现明显的AH。保留天然肾的移植后患者中AH的发病率更高（高2.3倍）。这与外周血浆肾素活性（RRA）较高相关。作者建议，该方案应用于移植前后AH表现的诊断，其中包括考虑疾病终末期的病因、血液透析卡托普利试验中AH变化的特征、放射心动图检查、间接肾血管造影（99-锝高锝酸盐），或在分两阶段进行双侧肾切除术的情况下进行RPA选择性血液检测。对于接受肾移植的患者，诊断方案应包括双脉冲多普勒超声检查、移植肾动脉造影检查以及卡托普利负荷试验的药物肾造影。证明了在选择性采血期间卡托普利刺激肾素分泌的可行性。作者验证了双侧肾切除术后患者肾素活性、醛固酮、皮质醇和促肾上腺皮质激素浓度的时间进程，确定了与AH相关的双侧肾切除术的适应症，并讨论了其可能的结果。（摘要截断于250字）
