RENAL BIOPSY STUDIES CORRELATED WITH RENAL CLEARANCE OBSERVATIONS IN HYPERTENSIVE PATIENTS TREATED BY RADICAL SYMPATHECTOMY 1

Abstract

Renal clearance studies performed on 20 patients with essential hypertension showed a significant correlation with the microscopic appearance of their respective renal tissues which were removed for biopsy at the time of sympathectomy, i.e., the more severe the renal vascular disease, the more reduced were the glomerular filtration rate and the renal blood flow. In the cases with grade O and I renal vascular disease, the renal clearance observations were either normal or only very .slightly reduced. Only in grade IV renal vascular disease was renal blood flow seriously reduced. The filtration fraction was normal in 7 out of 8 cases in biopsy groups O, I and II. It was increased in 6 of 11 cases in biopsy groups III and IV. These findings indicate that constriction of the efferent glomerular arterioles was not present in the early stages of renal vascular disease. Bilateral radical lumbo-dorsal splanchnicectomy had relatively little effect on renal clearance, when measured in the horizontal position. Although glomerular filtration was reduced about 20% in the immediate post-operative period it returned within a yr. to its preoperative level and was maintained at this level. Renal plasma flow was essentially unchanged.