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Renal Hypertension, Heart Failure, and Azotemia: Report of a Case Treated Successfully by Nephrectomy

Renal Hypertension, Heart Failure, and Azotemia: Report of a Case Treated Successfully by... Abstract Frequent reports have appeared in the urological literature dealing with the diagnosis and treatment of renal hypertension.1-6 Emphasis has been placed on clinical history, intravenous pyelography, divided function studies, renal angiography, and more recently the radioisotope renogram.7 Unexplained flank pain followed by the abrupt onset of severe hypertension naturally alerts the physician to the possibility of segmental or main renal artery thrombosis or embolism, but more often the history is less suggestive or unremarkable. Intravenous pyelograms and tests of total renal function are frequently normal, and divided function studies are subject to considerable error, in both performance and interpretation. Renal angiography, while important in the ultimate preoperative evaluation of the patient with suspected renal hypertension, has certain attendant hazards and should not be used as a routine diagnostic procedure. In the preoperative evaluation of the patient with renal hypertension it has generally been emphasized that total renal function References 1. Smith, H. W.: Unilateral Nephrectomy in Hypertensive Disease , J Urol 76:685, 1956. 2. Connor, T. B.; Berthrong, M.; Thomas, W. C.; and Howard, J. E.: Hypertension Due to Unilateral Renal Disease, With a Report on a Functional Test Helpful in Diagnosis , Bull Hopkins Hosp 100:241-276, 1957. 3. DeCamp, P. T., and Birchall, R.: Recognition and Treatment of Renal Arterial Stenosis Associated With Hypertension , Surgery 43:134, 1958. 4. McDonald, D. F.: Individual Renal Clearance in Diagnosis of Hypertension of Renal Origin , J Urol 86:289-294, 1961. 5. Straffon, R. A., and Garcia, A. M.: A Clinical Evaluation of the Radioactive Diodrast Renogram as a Screening Test in Hypertension , J Urol 83: 774-781, 1960. 6. Stokes, J. M.; Wohltmann, H.; and Carlson, E.: Coarctation of the Abdominal Aorta and Renal Artery Stenosis Corrected by Surgical Treatment: The Importance of Individual Renal Function Tests in Selection of Proper Management , Ann Surg 152:856-860, 1960.Crossref 7. Winter, C. C.; Maxwell, M. H.; Rockney, R. E.; and Kleeman, C. R.: Results of the Radioisotope Renogram and Comparison With Other Kidney Tests Among Hypertensive Individuals , J Urol 59:674, 1959. 8. Yendt, E. R.; Kerr, W. K.; Wilson, D. R.; and Jawarski, Z. F.: The Diagnosis and Treatment of Renal Hypertension, With Special Reference to a Case of Hypertension Due to Stenosis of Both Renal Arteries , Amer J Med 28:169, 1960.Crossref 9. Grob, D.: Diagnosis and Management of the Curable Forms of Hypertension , Advance Intern Med 10:219-258, 1960. 10. Imber, I., and Clymer, R.: Obstruction of Renal Artery Producing Malignant Hypertension , New Eng J Med 252:8, 1955.Crossref 11. Margolin, E. G.; Merrill, J. P.; and Harrison, J. H.: Diagnosis of Hypertension Due to Occlusions of the Renal Artery , New Eng J Med 256:581, 1957.Crossref 12. Deming, O. B.: Association of Polyuria and Albuminuria With Hypertension of Unilateral Renal Origin , Arch Intern Med 93:197-204, 1954.Crossref 13. Moyer, J. H.; Heider, C.; Pevey, K.; and Ford, R. V.: The Effect of Treatment on the Vascular Deterioration Associated With Hypertension, With Particular Emphasis on Renal Function , Amer J Med 24:177, 1958.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Renal Hypertension, Heart Failure, and Azotemia: Report of a Case Treated Successfully by Nephrectomy

Archives of Surgery , Volume 87 (3) – Sep 1, 1963

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Publisher
American Medical Association
Copyright
Copyright © 1963 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1963.01310150166037
Publisher site
See Article on Publisher Site

Abstract

Abstract Frequent reports have appeared in the urological literature dealing with the diagnosis and treatment of renal hypertension.1-6 Emphasis has been placed on clinical history, intravenous pyelography, divided function studies, renal angiography, and more recently the radioisotope renogram.7 Unexplained flank pain followed by the abrupt onset of severe hypertension naturally alerts the physician to the possibility of segmental or main renal artery thrombosis or embolism, but more often the history is less suggestive or unremarkable. Intravenous pyelograms and tests of total renal function are frequently normal, and divided function studies are subject to considerable error, in both performance and interpretation. Renal angiography, while important in the ultimate preoperative evaluation of the patient with suspected renal hypertension, has certain attendant hazards and should not be used as a routine diagnostic procedure. In the preoperative evaluation of the patient with renal hypertension it has generally been emphasized that total renal function References 1. Smith, H. W.: Unilateral Nephrectomy in Hypertensive Disease , J Urol 76:685, 1956. 2. Connor, T. B.; Berthrong, M.; Thomas, W. C.; and Howard, J. E.: Hypertension Due to Unilateral Renal Disease, With a Report on a Functional Test Helpful in Diagnosis , Bull Hopkins Hosp 100:241-276, 1957. 3. DeCamp, P. T., and Birchall, R.: Recognition and Treatment of Renal Arterial Stenosis Associated With Hypertension , Surgery 43:134, 1958. 4. McDonald, D. F.: Individual Renal Clearance in Diagnosis of Hypertension of Renal Origin , J Urol 86:289-294, 1961. 5. Straffon, R. A., and Garcia, A. M.: A Clinical Evaluation of the Radioactive Diodrast Renogram as a Screening Test in Hypertension , J Urol 83: 774-781, 1960. 6. Stokes, J. M.; Wohltmann, H.; and Carlson, E.: Coarctation of the Abdominal Aorta and Renal Artery Stenosis Corrected by Surgical Treatment: The Importance of Individual Renal Function Tests in Selection of Proper Management , Ann Surg 152:856-860, 1960.Crossref 7. Winter, C. C.; Maxwell, M. H.; Rockney, R. E.; and Kleeman, C. R.: Results of the Radioisotope Renogram and Comparison With Other Kidney Tests Among Hypertensive Individuals , J Urol 59:674, 1959. 8. Yendt, E. R.; Kerr, W. K.; Wilson, D. R.; and Jawarski, Z. F.: The Diagnosis and Treatment of Renal Hypertension, With Special Reference to a Case of Hypertension Due to Stenosis of Both Renal Arteries , Amer J Med 28:169, 1960.Crossref 9. Grob, D.: Diagnosis and Management of the Curable Forms of Hypertension , Advance Intern Med 10:219-258, 1960. 10. Imber, I., and Clymer, R.: Obstruction of Renal Artery Producing Malignant Hypertension , New Eng J Med 252:8, 1955.Crossref 11. Margolin, E. G.; Merrill, J. P.; and Harrison, J. H.: Diagnosis of Hypertension Due to Occlusions of the Renal Artery , New Eng J Med 256:581, 1957.Crossref 12. Deming, O. B.: Association of Polyuria and Albuminuria With Hypertension of Unilateral Renal Origin , Arch Intern Med 93:197-204, 1954.Crossref 13. Moyer, J. H.; Heider, C.; Pevey, K.; and Ford, R. V.: The Effect of Treatment on the Vascular Deterioration Associated With Hypertension, With Particular Emphasis on Renal Function , Amer J Med 24:177, 1958.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Sep 1, 1963

References