Abstract
Renal clearance, natrium and potassium in serum and urine, blood nonprotein nitrogen and urinary excretion of aldosterone were studied on patients with renovascular, essential and malignant hypertension, Cushing's syndrome and pheochromocytoma. Similar studies were made on five normal persons as control.
The following results were obtained.
1) The normal values in average were as follows: Renal plasma flow 538.3 ml/min., renal blood flow 933.4 ml/min., glomerular filtration rate 116.7 ml/min., filtration rate 0.224, serum natrium 141.6 mEq/L, serum potassium 4.32 mEq/L, urine natrium 137.0 mEp/day, potassium-natrium ratio 0.25, blood nonprotein nitrogen 28.78 mg/dl, urinary excretion of aldosterone 4.56 ug/day,
2) Blood pressure was lowered two or three weeks later after successful renal artery reconstruction or nephrectomy in all patients with renovascular hypertension.
3) Renal plasma and blood flow, and glomerular filtration rate returned to nearly normal value after operation in all but one case where nephrectomy was made. No marked change was found in filtration rate.
4) No marked changes were found in serum natrium and potassium through pre-and postoperative course.
5) Natrium and potassium in urine increased after operation though no marked change was found in potassium-natrium ratio.
6) Blood nonprotein nitrogen decreased in the range of normal after operation.
7) Urinary excretion of aldosterone decreased defenitely after operation, although it did not return to normal value in some cases.
8) Renal plasma and blood flow, glomerular filtration rate and filtratiou rate were all within normal limits or slightly decreased in patients with essential hypertension. Definitely decreased renal plasma and blood flow, relatively normal filtration rate and slightly increased filtration rate were found in the case of malignant hypertension.
9) No marked changes were found in serum natrium and potassium in both essential and malignant hypertension.
10) Urinary excretion of natrium and potassium were slightly decreased in essential hypertension and definitely decreased in malignant hypertension.
11) Blood nonprotein nitrogen was within normal limits in essential hypertension, but definitely increased in malignant hypertension.
12) Urinary excretion of aldosterone was slightly increased in essential hypertension and definitely increased in malignant hypertension.
13) Blood pressure was definitely lowered after operation in each case of Cushing's syndrome and pheochromocytoma.
14) Renal plasma and blood flow returned to nearly normal value after operation in Cushing's syndrome. They were decreased after operation in pheochromocytoma, although its cause was unexplainable.
15) There were found no marked changes in natrium and potassium in serum and urine and blood nonprotein nitrogen through the course in both Cushing's syndrome and pheochromocytoma.
16) Urinary excretion of aldosterone was decreased, though within normal range, after operation in both Cushing's syndrome and pheochromocytoma.
17) It was concluded from the above data that mechanism of renal hypertension and stimulation factor of aldosterone excretion are due to Renin-Angiotensin II system, as which was proved in the experimental work.
