Ishimitsu T, Yagi H, Ohkubo M, Nakamura Y, Yagi S
Department of Medicine, Dokkyo University School of Medicine, Tochigi, Japan.
Am J Nephrol. 1994;14(1):60-3. doi: 10.1159/000168687.
A 61-year-old man developed renovascular hypertension characterized by nephrotic-range proteinuria. When he was treated with a calcium channel blocker, glomerular filtration fraction was 0.26 and massive proteinuria ranging from 10 to 15 g/day persisted. An angiotensin-converting enzyme inhibitor markedly reduced the proteinuria to 1-2 g/day with a filtration fraction of 0.20. After the antihypertensive drug was switched to a beta-blocker, the filtration fraction was 0.23 and urinary protein excretion was 3-4 g/day. Blood pressure control was comparable by each drug. These findings suggest a role of intraglomerular hydraulic mechanism in the etiology of massive proteinuria in renovascular hypertension.
一名61岁男性患肾血管性高血压，其特征为肾病范围蛋白尿。当用钙通道阻滞剂治疗时，肾小球滤过分数为0.26，且持续存在每天10至15克的大量蛋白尿。一种血管紧张素转换酶抑制剂使蛋白尿显著减少至每天1 - 2克，滤过分数为0.20。在将抗高血压药物换为β受体阻滞剂后，滤过分数为0.23，尿蛋白排泄为每天3 - 4克。每种药物对血压的控制效果相当。这些发现提示肾小球内液压机制在肾血管性高血压大量蛋白尿的病因学中起作用。
