The Granularity of the Juxtaglomerular Cells in Human Hypertension

Abstract

Renal biopsies were obtained in 40 hypertensive patients for the purpose of studying the granularity of the juxtaglomerular cells as a possible indication of renin secretion. Ten patients with juxtaglomerular hypergranularity manifested severe hypertension frequently in association with a clinical picture suggesting hyperaldosteronism. Pathologic lesions associated with increased granules included primarily lesions of the renal arterial tree such as renal artery stenosis and severe nephrosclerosis. One patient with toxemia of pregnancy was noted also to have prominent granularity, but no such increase was observed in a small group of patients with pyelonephritis, Cushing''s syndrome, coarctation of the thoracic aorta and primary aldosteronism unless nephrosclerosis was also present. Only five of sixteen patients with renal artery lesions had juxtaglomerular hypergranularity. Hypertension persisted in seven of these patients with normal granularity despite surgery. Three of four patients with increased granules, on the other hand, improved dramatically following surgery. It is suggested that a study of juxtaglomerular cell granules in patients with renal artery lesions may be helpful in the selection of such patients for surgery.