Role of the peripheral renin profile in predicting blood pressure control after bilateral nephrectomy in renal-transplant patients
| Autor: | Luis Estevan Ianhez, Elias David-Neto, Maurício de Carvalho Teixeira, Willian Nahas, E. Mazucchi |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Adult
Male medicine.medical_specialty Captopril medicine.medical_treatment Urology Blood Pressure Nephrectomy Plasma renin activity Renovascular hypertension Internal medicine Renin Humans Medicine Postoperative Period Antihypertensive Agents Transplantation Kidney business.industry medicine.disease Kidney Transplantation Angiotensin II Blood pressure medicine.anatomical_structure Endocrinology Nephrology Female business Forecasting Kidney disease |
| Zdroj: | Nephrology Dialysis Transplantation. 13:2092-2097 |
| ISSN: | 1460-2385 |
| Popis: | hypertension; renal transplantation; renin activity; bilateral nephrectomy; renovascular hypertension Background. The unregulated renin release by native kidneys is one of the factors responsible for the high incidence of hypertension after renal transplantation but, even after three decades of transplantation, there Introduction is still a lack of a method to identify it as the major cause of hypertension. Systemic arterial hypertension (SAH ) is present in Methods. We investigated whether or not peripheral almost half of the renal transplanted patients, a prevalrenin activity, before and 90 min after 25 mg of captop- ence much higher than in the normal population. ril, can play this role. One hundred and five consecutive Many factors, such as steroids and cyclosporin A patients with SCr less than 2 mg/dl were studied 18±8 (CsA), the presence of native kidneys, primary kidney months after renal transplantation. Forty-seven of disease etc, contribute for such high prevalence. them were considered hypertensive and 58 normotens- Certainly, hypertension in transplanted patients is ive. All hypertensive patients were submitted to the implicated in the development and the course of captopril test to analyse the peripheral renin activity chronic transplant nephropathy, since in both condiprofile. tions smooth-muscle cell proliferation in the vascular Results. In the hypertensive group, 17 patients (36%) wall is the main pathological event. In these terms, a were considered Renin-pos and 30 (64%) Renin-neg. better blood pressure (BP) control should be followed All Renin-pos (stimulated renin=19.1±6.4 ng/ml/h) by either a less frequent or less severe chronic allograft patients were submitted to bilateral nephrectomy functional deterioration. The same rationale has been (bNx) and re-evaluated 6 months later. All of them showed in experimental models of renal failure as well normalized renin activity (4.4±3.0 ng/ml/h, P= as in human renal disease where reduction of blood 0.0001) and 10 of 17 (60%) became normotensive and pressure slows the rate of kidney function decline. oV drugs. The remaining seven (40%) decreased the The presence of the native kidneys represents one of number of hypotensive drugs from 2.2±0.5 to the major causes of SAH after renal transplantation 0.5±0.7/pt/day. There was a correlation between b- once arterial hypertension is much less frequent in Renin and dBP (r=0.47, P |
| Databáze: | OpenAIRE |
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