Weidmann P, Beretta-Piccoli C, Steffen F, Blumberg A, Reubi F C
Kidney Int. 1976 Mar;9(3):294-301. doi: 10.1038/ki.1976.32.
Inverse interrelations between plasma renin activity and exchangeable sodium or blood volume were found in both normotensive (N = 23) and hypertensive (N =29) hemodialysis patients (r= 0.47; P less than 0.005); however, mean plasma renin for any given sodium/volume state was at least two-fold higher in hypertensive than in normotensive hemodialysis patients or normal subjects (N =31). In the hemodialysis patients, blood pressure correlated weakly but significantly with the products of circulating renin and exchangeable sodium (r=0.37; P less than 0.005) or blood volume (r = 0.29; P less than 0.05). Multiple regression analysis including duration of previous hypertension as the second independent variable increased these correlation coefficients to 0.44 and 0.42, respectively. This suggests that hypertension in endstage kidney disease is often associated with resetting of the body sodium/fluid=renin feedback mechanism. Inappropriately increased plasma renine activity relative to the body sodium/volume state as well as high blood pressure-induced vascular changes may play important complementary roles, but it appears evident that additional mechanisms are also operative in maintaining end-stage renal hypertension.
在正常血压（N = 23）和高血压（N = 29）的血液透析患者中均发现血浆肾素活性与可交换钠或血容量之间呈负相关（r = 0.47；P < 0.005）；然而，在任何给定的钠/容量状态下，高血压血液透析患者的平均血浆肾素水平至少是正常血压血液透析患者或正常受试者（N = 31）的两倍。在血液透析患者中，血压与循环肾素和可交换钠的乘积（r = 0.37；P < 0.005）或血容量（r = 0.29；P < 0.05）呈弱但显著的相关性。将既往高血压病程作为第二个自变量进行多元回归分析后，这些相关系数分别增至0.44和0.42。这表明终末期肾病患者的高血压常与机体钠/液体 - 肾素反馈机制的重置有关。相对于机体钠/容量状态，血浆肾素活性不适当升高以及高血压引起的血管变化可能起重要的互补作用，但显然还有其他机制也在维持终末期肾性高血压中起作用。
