Weidmann P, Reubi F
Schweiz Med Wochenschr. 1976 Dec 11;106(50):1778-90.
In about 15% of cases hypertension is caused by renal diseases, including unilateral and bilateral parenchymatous nephropathies, renal artery stenosis and renin producing tumors. Important pathogenic determinants are the sodium volume status and the renin angiotensin system. The level of the blood pressure may also depend on the duration of hypertension. An increase in peripheral resistance plays a more important role than an increase in cardiac index. Simultaneous determination of the renin activity in both renal veins is of decisive importance in the diagnosis of renal artery stenosis. Drug treatment of renal hypertension is not essentially different from that of essential hypertension. Surgical procedures include revascularization, uninephrectomy and, in uncontrollable hemodialysis patients, binephrectomy.
约15%的高血压病例由肾脏疾病引起，包括单侧和双侧实质性肾病、肾动脉狭窄以及肾素分泌肿瘤。重要的致病决定因素是钠容量状态和肾素 - 血管紧张素系统。血压水平也可能取决于高血压的持续时间。外周阻力增加比心指数增加起更重要的作用。同时测定双侧肾静脉中的肾素活性对肾动脉狭窄的诊断具有决定性意义。肾性高血压的药物治疗与原发性高血压的药物治疗本质上没有区别。外科手术包括血管重建术、单侧肾切除术，对于无法控制的血液透析患者，则进行双侧肾切除术。
