Podjarny E, Richter S, Magen H, Bachar L, Bernheim J
Isr J Med Sci. 1986 Dec;22(12):861-4.
Twenty-six normotensive patients, who underwent unilateral nephrectomy for nontumoral urological diseases, were reevaluated. The mean postoperative follow-up period was 13.8 +/- 0.7 years. Eleven patients developed hypertension, and 15 patients remained normotensive. The former were 47.1 +/- 3.3 years old, and the latter 36.5 +/- 2.9 years old at the time of nephrectomy (P less than 0.02). The mean preoperative systolic blood pressure was higher in the group of 11 hypertensive patients (126.7 +/- 2.4 mm Hg) than in the 15 normotensive patients (118.2 +/- 2.9 mm Hg), P less than 0.04. Preoperative diastolic blood pressure was similar in the two groups (77.8 +/- 1.5 vs. 75 +/- 2 mm Hg). Preoperative and follow-up serum creatinine levels were similar in both groups. Mean creatinine clearance (Ccr) at the time of follow-up was not significantly different in the hypertensive patients compared with the normotensive patients. One patient developed proteinuria and chronic renal failure (Ccr of 31 ml/min). Two other patients with normal Ccr had a daily protein excretion of 840 and 2,000 mg/24 h, respectively. The incidence of hypertension, after nephrectomy, of 75% in patients greater than 55 years old seems to be significantly higher than the 30% reported in an aged-matched normal Israeli population. This did not apply to the patients less than 55 years old. In most of the cases, long-term follow-up did not reveal significant uninephrectomy induced changes in renal function.
对26例因非肿瘤性泌尿系统疾病接受单侧肾切除术的血压正常患者进行了重新评估。术后平均随访期为13.8±0.7年。11例患者出现高血压，15例患者血压仍正常。肾切除时，前者年龄为47.1±3.3岁，后者为36.5±2.9岁（P<0.02）。11例高血压患者组术前平均收缩压（126.7±2.4mmHg）高于15例血压正常患者组（118.2±2.9mmHg），P<0.04。两组术前舒张压相似（77.8±1.5对75±2mmHg）。两组术前和随访时血清肌酐水平相似。随访时高血压患者的平均肌酐清除率（Ccr）与血压正常患者相比无显著差异。1例患者出现蛋白尿和慢性肾衰竭（Ccr为31ml/min）。另外2例Ccr正常的患者24小时尿蛋白排泄量分别为840和2000mg。55岁以上患者肾切除术后高血压发病率为75%，似乎显著高于年龄匹配的以色列正常人群报告的30%。这不适用于55岁以下的患者。在大多数情况下，长期随访未发现单侧肾切除引起肾功能的显著变化。
