Studies on the Renal Hypertension
II.Clinical Studies on the Osmolality of Differential Renal Urine in the Unilateral Renovascular Hypertension
1967 Volume 9 Issue 5 Pages 479-488
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1967 Volume 9 Issue 5 Pages 479-488
Differential renal function studies were performed on clinical cases in which renal hypertension were suspected. The examinations were carried out under oral administration of water, using the plastic whistle tip ureterol catheter with multiple eyes, introduced into the midpoint of each ureter. In this paper, the water metabolism in the kidney was chiefly investigated. The results cf examination in the controls and the unilateral renovascular hypertension are as follows : I. The results in the control group : Thirteen cases were picked up as controls, in which functional and organic chatges in the kidney were not recognized in the radioisotope renography and intravenous pyelography. 1) Under water diuresis, the U-Flow, RPF, GFR, U-Osmo and C-H2O were a little greater in the right kidney than in the left kidney. 2) The U-Osmo ranged from 16 mOsmo to 301 mOsmo in the right kidney and from 14 mOsmo to 288 mOsmo in the left kidney. The average value was 143 mOsmo in the right kidney and 132 mOsmo in the left kidney. 3) The C-Osmo ranged from 0.53 cc/min to 4.78 cc/min in the right kidney and from 0.41 cc/min to 4.74 cc/min in the left kidney. The average value was 2.24 cc/min in the right kidney and 2.14 ccj min in the left kidney. 4) The C-H2O ranged from 0.41 cc/min to 15.90 cc/min in the right kidney and from 0.07 cc/min to 15.60 cc/min in the left kidney. The average value was 3.56 cc/min in the right kidney and 3.30 cc j min in the left kidney. II. The results in the unilateral renal artery stenosis : 1) In the stenotic side, the U-Flow, RPF, GFR and C-Osmo were decreased, but U-PAH and U-Osmo were increased. 2) The ratio of U-Osmo of the stenotic kidney to the control was increased more than 1.06. 3) The ratio of U-PAH of the stenotic kidney to the control was increased more than 1.17. 4) The C-H2O was decreased in the stenotic side, however it gave negative value in some occassions. Even when the values of both side were negative, the absolute values in the stenotic kidney were greater than the opposite side. 5) When the ratios of U-Osmo and U-PAH of the left kidney to right kidney are greater than. 1.06 and 1. 17, unilateral renovascular hypertension of the increased side due to renal ischemia may be suggested and its probability is above 83% or more.
