Plasma Renin Activity before and after Allogeneic Kidney Transplantation in Man

Abstract

Renin activity in the peripheral blood has been studied in ten patients with terminal uremia before bilateral nephrectomy or renal transplantation, in nine patients after bilateral nephrectomy, and in ten patients after allogeneic kidney transplantation. Only three of the uremic patients had elevated values before bilateral nephrectomy in spite of the presence of severe hypertension, which produced eye ground changes and cardiomegaly, in eight of the ten. After bilateral nephrectomy renin activity has not been demonstrable in five cases of nine, while in the remaining four cases a low activity could be recorded. The disappearance of the renin activity from the serum has been studied in five patients immediately after bilateral nephrectomy. A more rapid disappearance has been observed with high initial value than with low. Serial determinations immediately following revascularization at renal transplantation have shown an outflow of renin activity into the blood, the degree of which seemed to be related to the length of the ischemic period. In the later course of the transplant a striking correlation has been observed between increased renin activity in the plasma and the occurrence of clinical rejection. In six cases, abnormally high renin activity has been measured during rejection, and in no case has renin activity been normal in the presence of rejection. A gradual rise in renin activity with time has been observed in three cases having no evidence of acute rejection-attack. An absolute relationship between renin activity in the plasma and serum sodium or blood pressure has not been observed.