Studies on hypertension accompanying renal failure: plasma renin activity and plasma angiotensinase activity in renal failure

Abstract

Plasma renin activity (PRA) and plasma angiotensinase (ATase) activity were measured in 3 patients with acute renal failure, 36 patients with chronic renal failure, 75 control patients with various types of hypertension or urological diseases, and 12 normal control subjects as well as in 18 dogs which were performed bilateral ureteral ligation, bilateral nephrectomy and control operation.The results were as follows:1) PRA was increased significantly in the bilateral ureteral ligation group and was undetectable in the bilateral nephrectomy group of dogs. Plasma ATase activity in these two groups showed no significant difference from that in control group.2) PRA was increased remarkably in 9 cases of renovascular hypertension and pyelonephritis in man. Other control groups rarely showed increased PRA. All of control groups were without marked by increased plasma ATase activity.3) In 8 cases of human renovascular hypertension, control renal venous renin activity was significantly higher than normal cntrol or peripheral venous renin activity. There was no remarkable difference in plasma ATase activity. PRA was increased significantly by sodium depletion but plasma ATase activity was unchanged.4) PRA in human acute renal failure was increased markedly during oliguric phase and returned to normal values during diuretic phase and was again increased during recovery phase. Plasma ATase activity was increased slightly only during diuretic phase. However, no definite conclusions were war ranted due to the insufficient number of examined cases.5) Although PRA and plasma ATase activity in human chronic renal failure ranged widely, an increasing tendency was seen as compared with control subjects. Marked increase in PRA was seen in 13.9% and marked increase in plasma ATase activity was seen in 19.4%.6) PRA was significantly incresed after hemodialysis of human chronic renal failure but plasma ATase activity was unchanged.7) A case of chronic renal failure with severe hypertension was presented, who became normotensive 10 days after bilateral nephrectomy. PRA was decreased gradually after bilateral nephrectomy and was undetectable after 48 hours. Plasma ATase activity showed a temporary decrease after bilateral nephrectomy but remained at the preoperative value thereafter. From the above results, the followings were concluded:PRA and plasma ATase activity were showed an increasing tendency in human chronic renal failure. There were a few renin-dependent hypertensions in chronic renal failure. Change of plasma ATase activity was nonspecific and did not show any correlation with PRA or levels of blood pressure.