Stríbrná J, Zabka J, Belán A, Rotnáglová Z, Kocandrle V, Kovác J, Dráb K
Czech Med. 1981;4(1-2):55-66.
Indications for the angiography, probability, of the diagnosis of renovascular hypertension and results of the surgical and medical treatment were considered in 16 patients with renal artery stenosis of the transplanted kidney. The evaluation shows that an increase in the blood pressure in patients with good, stabilized graft function is the most essential clinical symptom of the stenosis. An increase in the peripheral plasma renin activity is of diagnostic value only in the acute phase of the hypertension. The examination of the plasma renin activity in renal veins is valuable when deciding the indication for surgical therapy of hypertension. The results of surgical interventions in two patients with renal artery stenosis in the anastomosis supported the diagnosis of the renovascular hypertension and indicated that reason of the increased blood pressure and deterioration of the graft function need not be the same. In the course of the medical therapy 14 patients were followed--out of them ten patients for 1 to 4 years. The results showed the medical therapy had a good prognosis in these risk patients. Thus, the reconstruction of the artery is indicated only in the case of serious stenosis threatening the loss of graft function and in the case of the accelerated hypertension.
对16例移植肾肾动脉狭窄患者的血管造影指征、肾血管性高血压诊断的可能性以及手术和药物治疗结果进行了研究。评估显示，移植肾功能良好且稳定的患者血压升高是狭窄最主要的临床症状。外周血浆肾素活性升高仅在高血压急性期具有诊断价值。肾静脉血浆肾素活性检查在决定高血压手术治疗指征时具有重要价值。两名吻合口处肾动脉狭窄患者的手术干预结果支持肾血管性高血压的诊断，并表明血压升高和移植肾功能恶化的原因不一定相同。在药物治疗过程中，对14例患者进行了随访，其中10例患者随访了1至4年。结果表明，药物治疗对这些高危患者预后良好。因此，仅在严重狭窄威胁移植肾功能丧失以及急进性高血压的情况下才建议进行动脉重建。
