THE RENAL MANIFESTATIONS OF PHEOCHROMOCYTOMA: REPORT OF A CASE

Abstract

The effect of pheochromocytoma upon the cardiovascular system is now well known, but the renal and urinary changes are not so well recognized. The case of a 29-year-old white male is reported who presented intermittent proteinuria, hematuria and cylindruria over a period of almost five years. During this time, his renal plasma flow, glomerular filtration rate and the ratio of his renal blood flow to maximal tubular excretory function decreased; while the filtration fraction and the maximal tubular excretory function increased. At postmortem, following death from a cerebral hemorrhage, the arterioles of the kidneys showed muscular hypertrophy and hyalinized glomeruli with atrophy of their associated tubules. The latter were replaced with fibrous tissue associated with lymphocyte infiltration. The mechanism of the renal changes is unknown. It is postulated that the renal vasoconstriction leads to anoxia of the capillary tufts and tubular epithelium which causes the urinary abnormalities. The development of chronic hypertension and arteriosclerosis then induces permanent damage and the functional efficiency of the kidney markedly decreases.