UNILATERAL RENAL DISEASE AS A CAUSE OF HYPERTENSION: ITS DETECTION BY URETERAL CATHETERIZATION STUDIES

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Article1 March 1960UNILATERAL RENAL DISEASE AS A CAUSE OF HYPERTENSION: ITS DETECTION BY URETERAL CATHETERIZATION STUDIESTHOMAS B. CONNOR, M.D., WILLIAM C. THOMAS JR., M.D., LILLIAN HADDOCK, M.D., JOHN EAGER HOWARD, M.D.THOMAS B. CONNOR, M.D., WILLIAM C. THOMAS JR., M.D., LILLIAN HADDOCK, M.D., JOHN EAGER HOWARD, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-52-3-544 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIt has been amply demonstrated experimentally that renal ischemia can result in hypertension1-3 and that, in man, reduced arterial flow to one kidney may produce a clinical picture indistinguishable at the bedside from so-called "essential" hypertension.4-7 Following Butler's initial observations in 1937 of the relief of hypertension in a child after the removal of a diseased kidney,8 many reports appeared on the results of nephrectomy for hypertension. Up to 1954 the percentage of "cures" in any sizable series of cases was remarkably low, and rarely did more than 20% of operations provide the desired fall in blood pressure.9-11The search...Bibliography1. GoldblattLynchHanzalSummerville HJRFWW (a) : Studies on experimental hypertension. I. The production of persistent elevation of systolic blood pressure by means of renal ischemia, J. Exper. Med. 59: 347, 1934. (b) Goldblatt, H.: The renal origin of hypertension, 1948, Charles C Thomas, Springfield, Illinois. CrossrefMedlineGoogle Scholar2. WilsonByrom CFB: Renal changes in malignant hypertension; experimental evidence, Lancet 1: 136, 1939. CrossrefGoogle Scholar3. Drury DR: The production by a new method of renal insufficiency and hypertension in the rabbit, J. Exper. Med. 68: 693, 1938. CrossrefMedlineGoogle Scholar4. HowardBerthrongSloanYendt JEMRDER: Relief of malignant hypertension by nephrectomy in four patients with unilateral renal vascular disease, Tr. A. Am. Physicians 66: 164, 1953. MedlineGoogle Scholar5. HowardBerthrongGouldYendt JEMDMER: Hypertension resulting from unilateral renal vascular disease and its relief by nephrectomy, Bull. Johns Hopkins Hosp. 94: 51, 1954. MedlineGoogle Scholar6. PoutasseDustan EFH (a) : Urologic causes of hypertension. I. Hypertension due to renal artery lesions, Cleveland Clin. Quart. 23: 3, 1956. (b) Poutasse, E. F.: Occlusion of a renal artery as a cause of hypertension, Circulation 13: 37, 1956. CrossrefGoogle Scholar7. LeadbetterBurkland WFCE (a) : Hypertension in unilateral renal disease, J. Urol. 39: 611, 1938. (b) Howard, T. L., Forbes, R. P., and Lipscomb, W. R.: Aneurysm of the left renal artery in a child five years old with persistent hypertension, J. Urol. 44: 808, 1940. (c) Perry, C. B.: Malignant hypertension cured by unilateral nephrectomy, Brit. Heart J. 7: 139, 1945. (d) Cornwell, P. M.: Hypertension due to partial renovascular occlusion, New England J. Med. 241: 1006, 1949. (e) Malisoff, S., and Macht, M. B.: Thromboangiitic occlusion of the renal artery with resultant hypertension, J. Urol. 65: 371, 1951. (f) Imber, I., and Clymer, R. H.: Obstruction of the renal artery producing hypertension, New England J. Med. 252: 301, 1955. (g) Margolin, E. G., Merrill, J. P., and Harrison, J. H.: Diagnosis of hypertension due to occlusions of the renal artery, New England J. Med. 256: 581, 1957. (h) McDonald, R. T., Szilagyi, D. E., and Smith, R. F.: Nephrogenic hypertension (Goldblatt kidney) following operative trauma to the renal artery, Circulation 18: 71, 1958. (i) Gellman, D. D.: Reversible hypertension and unilateral renal artery disease, Quart. J. Med. (New Series) 27: 103, 1958. CrossrefGoogle Scholar8. Butler AM: Chronic pyelonephritis and arterial hypertension, J. Clin. Investigation 16: 889, 1937. CrossrefMedlineGoogle Scholar9. Smith HW: Hypertension and urologic disease, Am. J. Med. 4: 724, 1948. CrossrefMedlineGoogle Scholar10. ThompsonSmithwick JERH: Human hypertension due to unilateral renal disease with special reference to renal artery lesions, Angiology 3: 493, 1952. CrossrefMedlineGoogle Scholar11. PickeringHeptinstall GWRH: Nephrectomy and other treatment for hypertension in pyelonephritis, Quart. J. Med. (New Series) 22: 1, 1953. MedlineGoogle Scholar12. ConnorBerthrongThomasHoward TBMWCJE: Hypertension due to unilateral renal disease—with a report on a functional test helpful in diagnosis, Bull. Johns Hopkins Hosp. 100: 241, 1957. MedlineGoogle Scholar13. White HL (a) : The excretion of sodium in relation to glomerular filtration, in Renal function, Transactions of the Second Conference, Bradley, S. E., Ed., 1950, Josiah Macy, Jr. Foundation, New York, p. 127. (b) Mueller, B. B., Surtshin, A., Carlin, M. R., and White, H. L.: Glomerular and tubular influences on sodium and water excretion, Am. J. Physiol. 165: 411, 1951. Google Scholar14. BerlinerDavidson RWDG: Production of hypertonic urine in the absence of pituitary antidiuretic hormone, J. Clin. Investigation 36: 1416, 1957. CrossrefMedlineGoogle Scholar15. Hald PM: The flame photometer for the measurement of sodium and potassium in biological materials, J. Biol. Chem. 167: 499, 1947. CrossrefMedlineGoogle Scholar16. Yendt ER: The diagnosis and treatment of renal hypertension, Am. J. Med., in press. Google Scholar17. Stamey TA: Personal communication. Google Scholar18. Winter CC: Unilateral renal disease and hypertension: use of radioactive Diodrast renogram as a screening test, J. Urol. 78: 107, 1957. CrossrefMedlineGoogle Scholar19. BirchallBatsonMoore RHMCB: Hypertension due to unilateral renal arterial obstruction: preliminary observations on the contribution of differential renal clearance studies, Am. Heart J. 56: 616, 1958. CrossrefMedlineGoogle Scholar20. SchlegelSavlovGabor JUEDF: Studies in renal hypertension, J. Urol. 81: 581, 1959. CrossrefMedlineGoogle Scholar21. PoutasseDonnellyDustan EFAHP: Separated kidney function tests in hypertensive patients, Surg. Forum 9: 826, 1958. MedlineGoogle Scholar22. PageDustanPoutasse IHHPEF: Mechanisms, diagnosis and treatment of hypertension of renal vascular origin, Ann. Int. Med. 51: 196, 1959. LinkGoogle Scholar23. PoutasseHumphriesMcCormickCorcoran EFAWLJAC: Bilateral stenosis of renal arteries and hypertension, J. A. M. A. 161: 419, 1956. CrossrefMedlineGoogle Scholar24. DeCampBirchall PTR: Recognition and treatment of renal arterial stenosis associated with hypertension, Surgery 43: 134, 1958. MedlineGoogle Scholar25. PartonNabseth CWDC: Splenorenal arterial anastomosis in the treatment of stenosis of the renal artery, New England J. Med. 259: 384, 1958. CrossrefMedlineGoogle Scholar26. BlockBurrows JBBA: Diagnostic use of I-131 Diodrast in hypertension due to unilateral renal disease, Circulation 18: 696, 1958. Google Scholar27. McAfeeWilson JGJK: A review of the complications of translumbar aortography, Am. J. Roentgenol., Rad. Therap. and Nucl. Med. 75: 956, 1956. MedlineGoogle Scholar28. McAfee JG: A survey of complications of abdominal aortography, Radiology 68: 825, 1957. CrossrefMedlineGoogle Scholar29. KincaidDavis OWGD: Abdominal aortography, New England J. Med. 259: 1017 and 1067, 1958. CrossrefMedlineGoogle Scholar30. Kincaid-Smith P: Vascular obstruction in chronic pyelonephritic kidneys and its relation to hypertension, Lancet 2: 1263, 1955. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Baltimore, Maryland*Received for publication September 29, 1959.†Presented in part at the Fortieth Annual Session of The American College of Physicians, Chicago, Illinois, April 21, 1959.From the Department of Medicine, The Johns Hopkins University School of Medicine and Hospital, and the Department of Medicine, University of Maryland, School of Medicine, Baltimore, Maryland.This work supported in part by Grant No. 2A-5058 from the Institute of Arthritis and Metabolic Diseases of the National Institutes of Health (U.S.P.H.S.).‡Present address: Department of Medicine, University of Florida College of Medicine, Gainesville, Florida.§Trainee, National Institute of Arthritis and Metabolic Diseases, Department of Medicine, Johns Hopkins University School of Medicine. Present address: Department of Medicine, San Juan City Hospital, San Juan, Puerto Rico.Requests for reprints should be addressed to Thomas B. Connor, M.D., Department of Medicine, University Hospital, Baltimore 1, Maryland. 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CALDWELL, M.D.Surgical Significance of Vascular Variations in Systemic Hypertension, with Especial Reference to Aberrant Renal ArteriesReconstructive Vascular SurgeryReversible renal hypertensionClinical evaluation of hypertensive patientsRenovascular hypertensionTypes of renal hypertension correctible by surgical therapyThe Surgical Significance of Aberrant Renal Arteries in Relation to Systemic HypertensionIndividual Renal Clearance in Diagnosis of Hypertension of Renal OriginRENAL ISCHAEMIA AND HYPERTENSION : A REVIEW OF THE RESULTS OF SURGERYRenal Arteriography and Differential Renal Function Tests in the Diagnosis of Unilateral Renal HypertensionTHE DIAGNOSIS AND TREATMENT OF HYPERTENSION DUE TO UNILATERAL RENAL DISEASEThe Radio-renogram, with Radio-renografin-I 131 , as a Diagnostic Aid in Urologic ProblemsModification of the Howard Test for the Detection of Renal-Artery ObstructionReviews of BooksRenal Hypertension 1 March 1960Volume 52, Issue 3Page: 544-559KeywordsArthritisAttentionHospital medicineHypertensionMetabolic disordersObstetrics and gynecologyRenal diseasesRenal ischemiaSodiumUrology ePublished: 1 December 2008 Issue Published: 1 March 1960 PDF downloadLoading ...