Delin K, Aurell M, Granerus G
Acta Med Scand. 1977;201(4):345-51. doi: 10.1111/j.0954-6820.1977.tb15710.x.
The practical value of renin secretion studies in hypertension associated with unilateral kidney disease, other than renal artery stenosis, has not been documented. This study, comprising 19 patients of this kind, disclosed three who had an abnormal renin secretion from the diseased kidney. The level of peripheral renin under basal conditions, and the change from this level as a result of provocation of renin secretion, were used to evaluate the importance of an arteriovenous renin gradient in the diseased kidney. The three patients were the only ones to become normotensive when the diseased kidney was removed in seven of the cases studied. When nephrectomy is considered in severe hypertension with unilateral kidney disease, there is a place for renin secretion studies, but a screening procedure is advisable. Measuring peripheral renin under basal conditions and after provocation of renin secretion, should reveal whether the renin-angiotensin system might be playing a part in maintaining the high BP. The finding of diminishing kidney function in many of the patients, despite good BP control, emphasizes the importance of sparing kidney function whenever possible.
肾素分泌研究在除肾动脉狭窄外的单侧肾脏疾病相关性高血压中的实用价值尚未得到证实。本研究纳入了19例此类患者，发现其中3例患侧肾脏存在肾素分泌异常。通过基础状态下外周肾素水平以及肾素分泌激发后该水平的变化，来评估患侧肾脏动静脉肾素梯度的重要性。在研究的7例病例中，这3例患者在切除患侧肾脏后血压恢复正常。对于单侧肾脏疾病所致的严重高血压患者，考虑行肾切除术时，肾素分泌研究有其应用价值，但建议进行筛查。测量基础状态下及肾素分泌激发后的外周肾素水平，应能揭示肾素 - 血管紧张素系统是否可能在维持高血压中起作用。尽管许多患者血压控制良好，但肾功能仍逐渐减退，这一发现强调了尽可能保留肾功能的重要性。
