本態性高血圧症および糸球体腎炎における腎血流量の動きと諸症状並びに予後との関係にかんする研究

抄録

The measurement of RBF is now considered to be the most sensitive method for evaluating the renal function. However, the relation between RBF and prognosis is not yet thoroughly clarified in essential hypertension and glomerulonephritis.
In the present studies, correlations among RBF by clearance method, other cardinal symptoms, complications and prognosis were examined in 271 patients with essential hypertension and 71 patients with glomerulonephritis.
In essential hypertension, RBF was observed to decrease gradually and progressively with duration of hypertension, and significant changes of RBF observed after average 24.8 months in patients under no antihypertensive treatment were as follows; increased in 0, no change in 31.2%, decreased in 68.8%. In chronic glomerulonephritis, RBF showed the following changes after average 19.1 months; increased in 26.7%, no changes in 20.0%, decreased in 53.3%. However in active stage of this disease RBF showed more rapid decrease than in essential hypertension.
Correlations between decrease of RBF and severity of retinal findings as found in essential hypertension were not observed in chronic glomerulonephritis, and it was suggested that both hypertension and renal damages were participated in the pathogenesis of retinal changes.
In chronic glomerulonephritis the hemoglobin content of blood was found to have correlation with decrease of RBF, but there were observed no correlations between edema or proteinuria and RBF. Many cases of both diseases with severe electrocardiographic changes, showed significant decrease of RBF, however, no direct relation was observed between severity of ECG and decrease of RBF.
In essential hypertension cerebral and cardiac complications occured in high percentage in patients with decreased RBF, but it was noted that they might sometimes occur in patients whose RBF remained in normal range. Cors quently, no direct relations were found between occurance of these complications and decrease of RBF.
Prognosis became poor and life survival shortend with the progress of decrease of RBF in both diseases. It was further noted that the decrease of RBF predicted generally more severe prognosis in essential hypertension than in chronic glomerulonephritis, because of the fact that in the latter the most common cause of death is uremia, while in the former cerebral and cardiac complications as well as uremia may be common cause of death