Zawada E T, Maxwell M H, Marks L S, Lee D B, Kaufman J J
J Urol. 1980 Feb;123(2):148-52. doi: 10.1016/s0022-5347(17)55829-2.
Saralasin was used as a functional test of the renin-angiotensin axis in 4 renal transplant patients with hypertension. Blood pressure was recorded by an automatic recording device and plasma renin activity was measured by radioimmunoassay of angiotensin I. A positive saralasin test suggested renin-mediated hypertension despite normal peripheral renin levels in a 40-year-old man whose original kidney disease was nephrosclerosis. Since the blood pressure was refractory to intravenous sodium nitroprusside saralasin was used for 14 hours to control blood pressure before and after arteriography in the patient. Removal of the native kidneys markedly ameliorated the hypertension. A 35-year-old woman with transplant hypertension was responsive to angiotensin blockade only during a period of abrupt worsening of blood pressure associated with an acute rejection episode. Finally, 2 patients with advanced chronic rejection responded to saralasin administration. These studies confirm that 1) angiotensin blockade is a useful tool in the diagnosis of renin-dependent hypertension even when plasma renin levels are not elevated, 2) saralasin can be used to control renin-dependent forms of hypertension that are refractory to intravenous sodium nitroprusside therapy and 3) transplant hypertension associated with acute and chronic rejection appears to be renin-dependent.
将沙拉新用于4例肾移植术后高血压患者的肾素 - 血管紧张素轴功能测试。通过自动记录装置记录血压，并通过放射免疫分析法测定血管紧张素I来测量血浆肾素活性。在一名40岁男性患者中，尽管外周肾素水平正常，但沙拉新试验呈阳性提示为肾素介导的高血压，其原发病为肾硬化症。由于该患者血压对静脉注射硝普钠无反应，在动脉造影前后使用沙拉新14小时来控制血压。切除自身肾脏后高血压明显改善。一名35岁的肾移植术后高血压女性患者仅在与急性排斥反应相关的血压突然恶化期间对血管紧张素阻断有反应。最后，2例晚期慢性排斥反应患者对沙拉新给药有反应。这些研究证实：1）血管紧张素阻断是诊断肾素依赖性高血压的有用工具，即使血浆肾素水平未升高；2）沙拉新可用于控制对静脉注射硝普钠治疗无反应的肾素依赖性高血压形式；3）与急性和慢性排斥反应相关的移植后高血压似乎是肾素依赖性的。
