Measurement of renin in both renal veins. Its use in diagnosis of renovascular hypertension

Abstract

Plasma renin activity in the effluent blood from both kidneys was assayed in a series of 35 patients with hypertension in an attempt to assess its value in predicting the response to corrective renovascular surgery. In 12 out of 13 patients with essential hypertension, the values observed on the left and the right sides were in close agreement with each other; the ratio of the higher value to the lower was 1.4 or less. In 17 out of 18 patients whose hypertension was either cured or distinctly improved by unilateral corrective operations, the pre-operative plasma renin activity in effluent blood from the affected side exceeded that of the other side by a factor of 1.5 or more. In 2 out of 3 patients who were unimproved by operation, the preoperative plasma renin activity values were comparatively low and were approximately the same for the 2 sides. In 1 patient with bilateral renal artery stenosis, the renal effluent plasma renin activity values were symmetrically elevated prior to operation, became characteristic of unilateral renal artery stenosis after corrective surgery on 1 side, and became normal after corrective surgery on the 2nd side.