Enhanced activity of sympathetic renal nerves in hypertensive patients with unilateral renal ischemia--its relationship to plasma renin activity in renal venous blood
Wiecek, A.; Heidland, A.; Gilge, U.; Kokot, F.; Kuczera, M.; Kiersztejn, M.
Clinical Nephrology 40(6): 326-331
1993
ISSN/ISBN: 0301-0430 PMID: 8299240 Document Number: 410274
In 16 hypertensive patients with significant unilateral renal artery stenosis plasma renin activity (PRA) and plasma levels of adrenaline (A), noradrenaline (NA) and dopamine were assessed in arterial blood, renal venous blood of the ischemic (IK) and normally (NK) perfused kidney and in blood withdrawn from the inferior vena cava, distally from the orifices of the renal veins. Plasma levels of A (= 661.8 +- 187.7 pg/ml) and NA (= 396.3 +- 72.5 pg/ ml) in renal venous blood of the ischemic kidney were significantly greater than in renal venous blood of the normally perfused kidney (A = 123.4 +- 16,0 pg/ml; NA = 277.2 +- 55.6 pg/ml) and than in arterial blood (A = 68.44 +- 8.4 pg/ml; NA = 192.8 +- 28.9 pg/ml) and inferior vena cava blood (A = 67.8 +- 7.5 pg/ml; NA 182.6 +- 26.8 pg/ml). In contrast to A and NA, plasma D level in renal venous blood of the normally perfused kidney was significantly higher (= 27,9 +- 4,9 pg/ml) than in renal venous blood of the ischemic kidney (= 14.3 +- 2.1 pg/ml) and than in arterial blood (= 16.1 +- 1.9 pg/ml) and in blood of the inferior vena cava (= 16.3 +- 1.8 pg/ml). A significant positive correlation was found between PRA and plasma levels of A and NA respectively only in renal venous blood of the ischemic kidney. From results obtained in this study it follows, that hypertensive patients with significant unilateral renal artery stenosis are characterized by enhanced activity of sympathetic renal nerves and that sympathetic overactivity of renal nerves may be related to enhanced generation of angiotensin II in the ischemic kidney.