Divided renal function test has been recommended as an excellent diagnostic tool for unilateral renal hypertension. But the criteria of this test for unilateral renal hypertension; i. e. reductoin of urine volume over 50% and urinary sodium concentration over 20% as compared with mate kidney, is not always observed in clinical cases.
This report is based on the results of divided renal function studies in twenty-six dogs in which hypertension was produced experimentally with constriction of unilateral renal artery, and the results were compared with those of stop flow method performed in nine of the hypertensive dogs. The dogs were divided into three groups depending on the period of hypertension following constriction of unilateral renal artery; the first stage, until the tenth
day
after constriction; the second stage, from eleventh
day
to one month; and third stage, from one month to six months. Volume, acidity and osmolarity of urine, sodium, potassium and chloride concentration of urine, and C
PAH, C
IN and PSP excretion were examined.
Conclusions are as follows.
1) Results of divided renal function studies were varied depending on the stage of renal hypertension.
2) The criteria of the divided renal function test for unilateral renal hypertension; i. e. reduction of urine volume over 50% and sodium concentration over 20% as compared with mate kidney, was not observed in most of the cases. The fact results from concomitant reduction of function of mate kidney. Therefore such a critera is not considered practical.
3) Following results were obtained from the kidney with constricted renal artery.
In the first stage, decrease of urine volume, C
PAH, C
IN and PSP excretion, and increase of osmolarity, acidity, potassium and chloride concentration of urine, were noted in all cases and decrease or increase of urinary sodium concentration in some.
In the second and the third stages, decrease of urine volume, acidity of urine, C
PAH, C
IN, PSP excretion and urinary sodium concentration, and increase of osmolarity, potassium and chloride concentration of urine are noted.
4) Stop flow method revealed that these results were mainly dependent on difference of function of the distal tubule between both kidneys.
5) Unilateral renal hypertension in almost all clinical cases are similar to the experimental hypertension in the second and the third stages. Therefore, the results in these experimental groups can be applied to clinical cases.
6) The results of this experiment bring about a new broad criteria of the divided renal function test for unilateral renal hypertension by which the disease will be diagnosed more frequently.
7) From this study it can be said that the tubular function may be revealed by the divided renal function studies and that indication for conservative operation for unilateral renal hypertension will be decided.
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