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EFFECTIVE RENAL BLOOD FLOW, GLOMERULAR FILTRATION RATE AND TUBULAR EXCRETORY MASS IN ARTERIAL HYPERTENSION: II. EFFECT OF SUPRADIAPHRAGMATIC SPLANCHNICECTOMY WITH LOWER DORSAL SYMPATHETIC GANGLIONECTOMY

EFFECTIVE RENAL BLOOD FLOW, GLOMERULAR FILTRATION RATE AND TUBULAR EXCRETORY MASS IN ARTERIAL... Abstract In a previous paper1 we reported the results of the determination of effective renal blood flow, glomerular filtration rate and tubular excretory mass by the diodrast and inulin clearance methods in 20 patients with arterial hypertension. It was concluded that arterial hypertension is associated with renal ischemia and that the reduction of blood supply to the kidney shows a definite correlation with the severity of the disease, as indicated by the changes, in the eyegrounds, the degree of thickening of the systemic arterioles, the renal function and the elevation of systolic and diastolic blood pressures. While this previous paper was in press, the results of similar studies were published by other investigators2 who also concluded that the rate of renal blood flow is decreased in most cases of hypertension. The purpose of this paper is to report the results of the determination of effective renal blood flow, glomerular References 1. Foà, P. P.; Woods, W. W.; Peet, M. M., and Foà, N. L.: Effective Renal Blood Flow, Glomerular Filtration Rate and Tubular Excretory Mass in Arterial Hypertension , Arch. Int. Med. 69:822 ( (May) ) 1942Crossref 2. abstracted, Am. J. Path. 17:446 ( (May) ) 1941. 3. Friedman, M.; Selzer, A., and Rosenblum, H.: The Renal Blood Flow in Hypertension as Determined in Patients with Variable, with Early and with Long-Standing Hypertension , J. A. M. A. 117:92 ( (July 12) ) 1941.Crossref 4. Goldring, W.; Chasis, H.; Ranges, H. A., and Smith, H. W.: Effective Renal Blood Flow in Subjects with Essential Hypertension , J. Clin. Investigation 20:637 ( (Nov.) ) 1941.Crossref 5. Chasis, H., and Redish, J.: Effective Renal Blood Flow in the Separate Kidneys of Subjects with Essential Hypertension , J. Clin. Investigation 20:655 ( (Nov.) ) 1941.Crossref 6. Peet, M. M.; Woods, W. W., and Braden, S.: The Surgical Treatment of Hypertension , J. A. M. A. 115:1875 ( (Nov. 30) ) 1940.Crossref 7. Peet, M. M.: Splanchnic Section for Hypertension: A Preliminary Report , Univ. Hosp. Bull., Ann Arbor 1:17 ( (June) ) 1935. 8. Blalock, A., and Levy, S. E.: Studies on the Etiology of Renal Hypertension , Ann. Surg. 106:826 ( (Nov.) ) 1937.Crossref 9. Freeman, N. E., and Page, I. H.: Hypertension Produced by Constriction of the Renal Artery in Sympathectomized Dogs , Am. Heart J. 14:405 ( (Oct.) ) 1937.Crossref 10. Goldblatt, H., and Wartman, W. B.: Studies on Experimental Hypertension: VI. The Effect of Section of Anterior Spinal Nerve Roots on Experimental Hypertension Due to Renal Ischemia , J. Exper. Med. 66:527 ( (Nov.) ) 1937.Crossref 11. Goldblatt, H.; Gross, J., and Hanzal, R. F.: Studies on Experimental Hypertension: II. The Effect of Resection of Splanchnic Nerves on Experimental Renal Hypertension , J. Exper. Med. 65:233 ( (Feb.) ) 1937.Crossref 12. Glenn, F., and Lasher, E. P.: The Effect of Destruction of the Spinal Cord on the Artificial Production of Hypertension in Dogs , Am. J. Physiol. 124:106 ( (Oct.) ) 1938. 13. Herrick, J. F.; Essex, H. E., and Baldes, E. J.: Observations on the Flow of Blood of the Kidney , Am. J. Physiol. 99:696 ( (Feb.) ) 1932. 14. Schneider, M., and Wildbolz, E.: Dekapsulation und Enervation der Niere und Nierendurchblutung , Ztschr. f. urol. Chir. 43:1, 1937. 15. Hermann, M., and Jourdan, F.: Verification par la méthode des dégénérescences de la systématisation ganglionnaire des voies vasoconstrictives du rein , Compt. rend. Soc. de biol. 124:1108, 1937. 16. Arnott, W. M., and Kellar, R. J.: The Effect of Renal Denervation on the Blood Pressure in Experimental Renal Hypertension , J. Path. & Bact. 42:141 ( (Jan.) ) 1936. 17. Maegraith, B. G., and McLean, F. J.: Experimental Renal Hypertension in Rabbits: Effect of Section of Renal Nerves , J. Physiol. 92:44 P ( (Feb.) ) 1938. 18. Grimson, K. S.: The Sympathetic Nervous System in Neurogenic and Renal Hypertension , Arch. Surg. 43:284 ( (Aug.) ) 1941. 19. Smith, H. W.; Goldring, W., and Chasis, H.: The Measurement of the Tubular Excretory Mass, Effective Blood Flow and Filtration Rate in the Normal Human Kidney , J. Clin. Investigation 17:263 ( (May) ) 1938. 20. Standardization of Blood Pressure Readings, Joint Recommendations of the American Heart Association and the Cardiac Society of Great Britain and Ireland , Am. Heart J. 18:95 ( (July) ) 1938. 21. The reader will notice that the average preoperative values are not the same in table 1 as in table 2 and that they also differ from the average preoperative values given in the preceding paper. This is due to the fact that in each table preoperative averages were computed only on those patients who were examined at the postoperative time under consideration and that not all the patients who were reexamined two weeks after operation had a later check-up, or vice versa. Moreover, not all the patients who were studied preoperatively had further studies, and 2 new patients not reported in our preceding paper are included in these tables. 22. Alving, A. S.; Adams, W.; Grimson, K. S.; Scott, C., and Sandiford, I.: Effect of Bilateral Paravertebral Sympathectomy on the Cardiorenal System in Essential Hypertension , Proc. Inst. Med. Chicago 13:306 ( (Feb. 15) ) 1941. 23. Corcoran, A. C., and Page, I. H.: Renal Blood Flow and Sympathectomy in Hypertension , Arch. Surg. 42:1072 ( (June) ) 1941.Crossref 24. Selzer, A., and Friedman, M.: Effect of Bilateral Splanchnicectomy upon Renal Blood Flow in Hypertension , Proc. Soc. Exper. Biol. & Med. 48:429 ( (Nov.) ) 1941. 25. Mann, F. C.; Herrick, J. F.; Essex, H. E., and Baldes, E. J.: The Effect on the Blood Flow of Decreasing the Lumen of a Blood Vessel , Surgery 4:249 ( (Aug.) ) 1938. 26. Schroeder, H. A., and Steele, J. M.: The Behavior of Renal Blood Flow After Partial Constriction of the Renal Artery , J. Exper. Med. 72:707 ( (Dec.) ) 1940. 27. Corcoran, A. C., and Page, I. H.: Renal Blood Flow in Experimental Hypertension Due to Constriction of the Renal Artery , Am. J. Physiol. 133:P 249 ( (June) ) 1941. 28. Alpert, L. K., and Thomas, C. B.: Renal Function in Hypertensive Dogs , Bull. Johns Hopkins Hosp. 66:407 ( (June) ) 1940. 29. Friedman, M.; Sugarman, H., and Selzer, A.: The Relationship of Renal Blood Pressure and Blood Flow to the Production of Experimental Hypertension , Am. J. Physiol. 134:493 ( (Oct.) ) 1941. 30. Mansfield, J. S.; Weeks, D. M.; Steiner, A., and Victor, J.: Reduction of Experimental Renal Hypertension by Pexis of Spleen or Omentum on the Kidney , Proc. Soc. Exper. Biol. & Med. 40:708 ( (April) ) 1939. 31. Cerqua, S., and Samaan, A.: Cure of Experimental Renal Hypertension , Clin. Sc. 4:113 ( (Dec.) ) 1939. 32. Abrami, P.; Islin, M., and Wallich, R.: Essai de traitement de l'hypertension artérielle d'origine rénale par la revascularisation chirurgical du rein (néphro-omentopexie) , Presse méd. 47:137 ( (Jan.) ) 1939. 33. Goldberg, S.; Rodbard, S., and Katz, L. N.: Increased Collateral Blood Supply to the Kidney in Renal Hypertension , Surgery 7:869 ( (June) ) 1940. 34. Bruger, M., and Carter, R. F.: Nephro-Omentopexy and Nephromyopexy in the Treatment of Arterial Hypertension , Ann. Surg. 113:381 ( (March) ) 1941. 35. Corcoran, A. C., and Page, I. H.: Renal Aspects of Experimental and Clinical Hypertension , J. Lab. & Clin. Med. 26:1713 ( (Aug.) ) 1941. 36. Kohlstaedt, K. G., and Page, I. H.: Production of Renin by Constricting the Renal Artery of an Isolated Kidney Perfused with Blood , Proc. Soc. Exper. Biol. & Med. 43:136 ( (Jan.) ) 1940. 37. Parsons, R. J., and McMaster, P. D.: The Effect of the Pulse upon the Formation and Flow of Lymph , J. Exper. Med. 68:353 ( (Sept.) ) 1938. 38. Steele, J. M.: Evidence for General Distribution of Peripheral Resistance in Coarctation of the Aorta: Report of Three Cases , J. Clin. Investigation 20:473 ( (Sept.) ) 1941. 39. Bradley, S. E., and Parker, B.: The Hemodynamic Effects of Angiotonin in Normal Man , J. Clin. Investigation 20:715 ( (Nov.) ) 1941. 40. Wilkins, R. W., and Duncan, C. N.: The Nature of the Arterial Hypertension Produced in Normal Subjects by the Administration of Angiotonin , J. Clin. Investigation 20:721 ( (Nov.) ) 1941. 41. Wiggers, C. J.: Basic Hemodynamic Principles Essential to Interpretation of Cardiovascular Disorders , Bull. New York Acad. Med. 18:3 ( (Jan.) ) 1942. 42. Footnote 2. 43. Smith, Goldring and Chasis.10 44. Lamport, H.: The Relative Changes in Afferent and Efferent Arteriolar Resistance in the Normal Human Kidney , J. Clin. Investigation 20:545 ( (Sept.) ) 1941.Crossref 45. Smith, H. W.: Note on the Interpretation of Clearance Methods in the Diseased Kidney , J. Clin. Investigation 20:631 ( (Nov.) ) 1941.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

EFFECTIVE RENAL BLOOD FLOW, GLOMERULAR FILTRATION RATE AND TUBULAR EXCRETORY MASS IN ARTERIAL HYPERTENSION: II. EFFECT OF SUPRADIAPHRAGMATIC SPLANCHNICECTOMY WITH LOWER DORSAL SYMPATHETIC GANGLIONECTOMY

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Publisher
American Medical Association
Copyright
Copyright © 1943 American Medical Association. All Rights Reserved.
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0730-188X
DOI
10.1001/archinte.1943.00210030058005
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Abstract

Abstract In a previous paper1 we reported the results of the determination of effective renal blood flow, glomerular filtration rate and tubular excretory mass by the diodrast and inulin clearance methods in 20 patients with arterial hypertension. It was concluded that arterial hypertension is associated with renal ischemia and that the reduction of blood supply to the kidney shows a definite correlation with the severity of the disease, as indicated by the changes, in the eyegrounds, the degree of thickening of the systemic arterioles, the renal function and the elevation of systolic and diastolic blood pressures. While this previous paper was in press, the results of similar studies were published by other investigators2 who also concluded that the rate of renal blood flow is decreased in most cases of hypertension. The purpose of this paper is to report the results of the determination of effective renal blood flow, glomerular References 1. Foà, P. P.; Woods, W. W.; Peet, M. M., and Foà, N. L.: Effective Renal Blood Flow, Glomerular Filtration Rate and Tubular Excretory Mass in Arterial Hypertension , Arch. Int. Med. 69:822 ( (May) ) 1942Crossref 2. abstracted, Am. J. Path. 17:446 ( (May) ) 1941. 3. Friedman, M.; Selzer, A., and Rosenblum, H.: The Renal Blood Flow in Hypertension as Determined in Patients with Variable, with Early and with Long-Standing Hypertension , J. A. M. A. 117:92 ( (July 12) ) 1941.Crossref 4. Goldring, W.; Chasis, H.; Ranges, H. A., and Smith, H. W.: Effective Renal Blood Flow in Subjects with Essential Hypertension , J. Clin. Investigation 20:637 ( (Nov.) ) 1941.Crossref 5. Chasis, H., and Redish, J.: Effective Renal Blood Flow in the Separate Kidneys of Subjects with Essential Hypertension , J. Clin. Investigation 20:655 ( (Nov.) ) 1941.Crossref 6. Peet, M. M.; Woods, W. W., and Braden, S.: The Surgical Treatment of Hypertension , J. A. M. A. 115:1875 ( (Nov. 30) ) 1940.Crossref 7. Peet, M. M.: Splanchnic Section for Hypertension: A Preliminary Report , Univ. Hosp. Bull., Ann Arbor 1:17 ( (June) ) 1935. 8. Blalock, A., and Levy, S. E.: Studies on the Etiology of Renal Hypertension , Ann. Surg. 106:826 ( (Nov.) ) 1937.Crossref 9. Freeman, N. E., and Page, I. H.: Hypertension Produced by Constriction of the Renal Artery in Sympathectomized Dogs , Am. Heart J. 14:405 ( (Oct.) ) 1937.Crossref 10. Goldblatt, H., and Wartman, W. B.: Studies on Experimental Hypertension: VI. The Effect of Section of Anterior Spinal Nerve Roots on Experimental Hypertension Due to Renal Ischemia , J. Exper. Med. 66:527 ( (Nov.) ) 1937.Crossref 11. Goldblatt, H.; Gross, J., and Hanzal, R. F.: Studies on Experimental Hypertension: II. The Effect of Resection of Splanchnic Nerves on Experimental Renal Hypertension , J. Exper. Med. 65:233 ( (Feb.) ) 1937.Crossref 12. Glenn, F., and Lasher, E. P.: The Effect of Destruction of the Spinal Cord on the Artificial Production of Hypertension in Dogs , Am. J. Physiol. 124:106 ( (Oct.) ) 1938. 13. Herrick, J. F.; Essex, H. E., and Baldes, E. J.: Observations on the Flow of Blood of the Kidney , Am. J. Physiol. 99:696 ( (Feb.) ) 1932. 14. Schneider, M., and Wildbolz, E.: Dekapsulation und Enervation der Niere und Nierendurchblutung , Ztschr. f. urol. Chir. 43:1, 1937. 15. Hermann, M., and Jourdan, F.: Verification par la méthode des dégénérescences de la systématisation ganglionnaire des voies vasoconstrictives du rein , Compt. rend. Soc. de biol. 124:1108, 1937. 16. Arnott, W. M., and Kellar, R. J.: The Effect of Renal Denervation on the Blood Pressure in Experimental Renal Hypertension , J. Path. & Bact. 42:141 ( (Jan.) ) 1936. 17. Maegraith, B. G., and McLean, F. J.: Experimental Renal Hypertension in Rabbits: Effect of Section of Renal Nerves , J. Physiol. 92:44 P ( (Feb.) ) 1938. 18. Grimson, K. S.: The Sympathetic Nervous System in Neurogenic and Renal Hypertension , Arch. Surg. 43:284 ( (Aug.) ) 1941. 19. Smith, H. W.; Goldring, W., and Chasis, H.: The Measurement of the Tubular Excretory Mass, Effective Blood Flow and Filtration Rate in the Normal Human Kidney , J. Clin. Investigation 17:263 ( (May) ) 1938. 20. Standardization of Blood Pressure Readings, Joint Recommendations of the American Heart Association and the Cardiac Society of Great Britain and Ireland , Am. Heart J. 18:95 ( (July) ) 1938. 21. The reader will notice that the average preoperative values are not the same in table 1 as in table 2 and that they also differ from the average preoperative values given in the preceding paper. This is due to the fact that in each table preoperative averages were computed only on those patients who were examined at the postoperative time under consideration and that not all the patients who were reexamined two weeks after operation had a later check-up, or vice versa. Moreover, not all the patients who were studied preoperatively had further studies, and 2 new patients not reported in our preceding paper are included in these tables. 22. Alving, A. S.; Adams, W.; Grimson, K. S.; Scott, C., and Sandiford, I.: Effect of Bilateral Paravertebral Sympathectomy on the Cardiorenal System in Essential Hypertension , Proc. Inst. Med. Chicago 13:306 ( (Feb. 15) ) 1941. 23. Corcoran, A. C., and Page, I. H.: Renal Blood Flow and Sympathectomy in Hypertension , Arch. Surg. 42:1072 ( (June) ) 1941.Crossref 24. Selzer, A., and Friedman, M.: Effect of Bilateral Splanchnicectomy upon Renal Blood Flow in Hypertension , Proc. Soc. Exper. Biol. & Med. 48:429 ( (Nov.) ) 1941. 25. Mann, F. C.; Herrick, J. F.; Essex, H. E., and Baldes, E. J.: The Effect on the Blood Flow of Decreasing the Lumen of a Blood Vessel , Surgery 4:249 ( (Aug.) ) 1938. 26. Schroeder, H. A., and Steele, J. M.: The Behavior of Renal Blood Flow After Partial Constriction of the Renal Artery , J. Exper. Med. 72:707 ( (Dec.) ) 1940. 27. Corcoran, A. C., and Page, I. H.: Renal Blood Flow in Experimental Hypertension Due to Constriction of the Renal Artery , Am. J. Physiol. 133:P 249 ( (June) ) 1941. 28. Alpert, L. K., and Thomas, C. B.: Renal Function in Hypertensive Dogs , Bull. Johns Hopkins Hosp. 66:407 ( (June) ) 1940. 29. Friedman, M.; Sugarman, H., and Selzer, A.: The Relationship of Renal Blood Pressure and Blood Flow to the Production of Experimental Hypertension , Am. J. Physiol. 134:493 ( (Oct.) ) 1941. 30. Mansfield, J. S.; Weeks, D. M.; Steiner, A., and Victor, J.: Reduction of Experimental Renal Hypertension by Pexis of Spleen or Omentum on the Kidney , Proc. Soc. Exper. Biol. & Med. 40:708 ( (April) ) 1939. 31. Cerqua, S., and Samaan, A.: Cure of Experimental Renal Hypertension , Clin. Sc. 4:113 ( (Dec.) ) 1939. 32. Abrami, P.; Islin, M., and Wallich, R.: Essai de traitement de l'hypertension artérielle d'origine rénale par la revascularisation chirurgical du rein (néphro-omentopexie) , Presse méd. 47:137 ( (Jan.) ) 1939. 33. Goldberg, S.; Rodbard, S., and Katz, L. N.: Increased Collateral Blood Supply to the Kidney in Renal Hypertension , Surgery 7:869 ( (June) ) 1940. 34. Bruger, M., and Carter, R. F.: Nephro-Omentopexy and Nephromyopexy in the Treatment of Arterial Hypertension , Ann. Surg. 113:381 ( (March) ) 1941. 35. Corcoran, A. C., and Page, I. H.: Renal Aspects of Experimental and Clinical Hypertension , J. Lab. & Clin. Med. 26:1713 ( (Aug.) ) 1941. 36. Kohlstaedt, K. G., and Page, I. H.: Production of Renin by Constricting the Renal Artery of an Isolated Kidney Perfused with Blood , Proc. Soc. Exper. Biol. & Med. 43:136 ( (Jan.) ) 1940. 37. Parsons, R. J., and McMaster, P. D.: The Effect of the Pulse upon the Formation and Flow of Lymph , J. Exper. Med. 68:353 ( (Sept.) ) 1938. 38. Steele, J. M.: Evidence for General Distribution of Peripheral Resistance in Coarctation of the Aorta: Report of Three Cases , J. Clin. Investigation 20:473 ( (Sept.) ) 1941. 39. Bradley, S. E., and Parker, B.: The Hemodynamic Effects of Angiotonin in Normal Man , J. Clin. Investigation 20:715 ( (Nov.) ) 1941. 40. Wilkins, R. W., and Duncan, C. N.: The Nature of the Arterial Hypertension Produced in Normal Subjects by the Administration of Angiotonin , J. Clin. Investigation 20:721 ( (Nov.) ) 1941. 41. Wiggers, C. J.: Basic Hemodynamic Principles Essential to Interpretation of Cardiovascular Disorders , Bull. New York Acad. Med. 18:3 ( (Jan.) ) 1942. 42. Footnote 2. 43. Smith, Goldring and Chasis.10 44. Lamport, H.: The Relative Changes in Afferent and Efferent Arteriolar Resistance in the Normal Human Kidney , J. Clin. Investigation 20:545 ( (Sept.) ) 1941.Crossref 45. Smith, H. W.: Note on the Interpretation of Clearance Methods in the Diseased Kidney , J. Clin. Investigation 20:631 ( (Nov.) ) 1941.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Mar 1, 1943

References