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      Unilateral Parenchymatous Kidney Disease and Hypertension: Results of Nephrectomy and Medical Treatment

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          Abstract

          In the present study 43 patients with unilateral parenchymatous kidney disease and hypertension were investigated. 20 patients were nephrectomized, 23 treated with antihypertensive drugs. Both therapeutic approaches showed an excellent and sustained blood pressure-(BP)-lowering effect. BP fell from 185 ± 27/116 ± 13 to 138 ± 20/86 ± 10 mm Hg in the operated and from 194 ± 32/116 ± 13 to 149 ± 22/95 ± 12 mm Hg in the medically treated patients after 2 and 6 weeks, respectively (p < 0.001). BP was 142 ± 16/89 ± 11 and 136+ 16/90 ± 10 mm Hg at the long-term follow-up in the 2 subgroups. In the operated group 70% (n = 14) were cured, 20% (n = 4) were improved and 10% (n = 2) unimproved. In the medically treated group 65% (n = 15) were normotensive, 26% (n = 6) improved and 9% (n = 2) treatment resistant. No significant correlation between postoperative BP reduction and lateralization of renin secretion (PRA-ratio > 1.5) was found. Although cured patients showed a higher mean PRA-ratio, 4 patients with a PRA-ratio < 1.5 were cured (n = 2) or improved (n = 2) postoperatively. Our results document an excellent and sustained antihypertensive effect of both nephrectomy and medical treatment in patients with unilateral parenchymatous kidney disease and hypertension. They further limit the predictive value of renal venous renin determination in the preoperative workup.

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          Author and article information

          Journal
          NEF
          Nephron
          10.1159/issn.1660-8151
          Nephron
          S. Karger AG
          1660-8151
          2235-3186
          1985
          1985
          04 December 2008
          : 41
          : 3
          : 250-257
          Affiliations
          Department of Internal Medicine, Urological Clinic and Institute of Pathology, University Hospital Zürich, Switzerland; and Robert Bosch Krankenhaus, Stuttgart, FRG
          Article
          183592 Nephron 1985;41:250–257
          10.1159/000183592
          3903527
          © 1985 S. Karger AG, Basel

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          Page count
          Pages: 8
          Categories
          Original Paper

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