Zusammenfassung
Es wird berichtet über eine 32jährige Frau mit beidseitiger Nierenarterienstenose von über 50% auf beiden Seiten. Vor der chirurgischen Korrektur der linken Nierenarterie war die Reninaktivität im Nierenvenenplasma niedrig (0,3 ng/ml/h rechts und 0,42 links). Nach der Operation war der Blutdruck nur vorübergehend normalisiert. 4 Monate später war die linke Nierenarterie bei einer wiederholten Angiographie durchgängig, während die Stenose auf der rechten Seite unverändert war. Zu diesem Zeitpunkt war die Plasmareninaktivität im Nierenvenenblut links 5.12 und rechts 11.2. Die nachfolgende Operation der rechten Seite führte zu einer Normalisierung des Blutdrucks. Die Patientin zeigte nacheinander die Charakteristika renovaskulärer Hypertonie: des Typs „one kidney hypertension“ und des Typs „two kidney hypertension“. Unsere Ergebnisse deuten darauf hin, daß die Pathomechanismen dieser tierexperimentellen Modelle auch beim Menschen wirksam sind.
Summary
A 32-year old hypertensive woman with bilateral renal artery stenosis of more than 50% on both sides was studied. Renal vein renin levels were low (0.3 ng/ml/h on the right side and 0.42 on the left) before surgical correction of the left renal artery. Thereafter, blood pressure was only temporarily reduced. Four months later a repeat angiography demonstrated a widely patent left renal artery and the stenosis on the right side was unchanged. Renal vein renin was 5.12 on the left and 11.2 on the right. Subsequent operation on the right side lead to normalization of blood pressure. Thus, our patient seems to demonstrate in sequence the characteristics of the two types of experimental renovascular hypertension known as “one kidney hypertension” and “two kidney hypertension”. Our findings suggest that the pathomechanisms of these experimental models are operative in man too.
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Scherer, B., Uhlich, E., Weber, P.C. et al. Reversal of “one kidney” to “two kidney” type of goldblatt hypertension in a patient with bilateral renal artery stenosis. Klin Wochenschr 55, 907–910 (1977). https://doi.org/10.1007/BF01478827
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DOI: https://doi.org/10.1007/BF01478827