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STUDIES ON EXPERIMENTAL HYPERTENSION: XV. EXPERIMENTAL OBSERVATIONS ON HYPERTENSION ASSOCIATED WITH UNILATERAL RENAL DISEASE; EFFECT OF OCCLUSION OF THE URETER ON EXPERIMENTAL HYPERTENSION DUE TO UNILATERAL RENAL ISCHEMIA

STUDIES ON EXPERIMENTAL HYPERTENSION: XV. EXPERIMENTAL OBSERVATIONS ON HYPERTENSION ASSOCIATED... Abstract In the earliest studies on experimental hypertension due to renal ischemia1 it was shown that constriction of the main artery of only one kidney in a dog or a monkey is sufficient to cause elevation of the blood pressure. It was also shown in these and in later studies2 that this elevation does not usually persist indefinitely unless the other kidney is removed or unless the main artery of the other kidney is also constricted. In most dogs with unilateral renal ischemia the blood pressure returns to the preoperative level in six weeks or less, but in some the hypertension may persist at a high level for many months. The return of the blood pressure to normal obviously may be due (a) to the development of considerable accessory circulation to the ischemic kidney or (b) to the compensating, neutralizing or inhibiting effect of the contralateral normal kidney. The References 1. (a) Goldblatt, H.; Lynch, J.; Hanzal, R. F., and Summerville, W. W.: Studies on Experimental Hypertension: I. The Production of Persistent Elevation of Systolic Blood Pressure by Means of Renal Ischemia , J. Exper. Med. 59:347 ( (March) ) 1934.Crossref 2. (b) Goldblatt, H.: Studies on Experimental Hypertension: III. The Production of Persistent Hypertension in Monkeys (Macaque) by Renal Ischemia , J. Exper. Med. 65:671 ( (May) ) 1937.Crossref 3. Goldblatt, H.: (a) Studies on Experimental Hypertension: V. The Pathogenesis of Experimental Hypertension Due to Renal Ischemia , Ann. Int. Med. 11:69 ( (July) ) 1937Crossref 4. (b) Experimental Hypertension Induced by Renal Ischemia , in Harvey Lectures, 1937-1938 , Baltimore, Williams & Wilkins Company, 1938, pp. 237-275 5. Bull. New York Acad. Med. 14:523 ( (Sept.) ) 1938 6. (c) Studies on Experimental Hypertension: XII. The Experimental Production and Pathogenesis of Hypertension Due to Renal Ischemia , Am. J. Clin. Path. 10:40 ( (Jan.) ) 1940. 7. (a) Wood, J. E., and Cash, J. R.: Experimental Hypertension: Observations on Sustained Elevation of Systolic and Diastolic Blood Pressure in Dogs , J. Clin. Investigation 15:543 ( (Sept.) ) 1936.Crossref 8. (b) Elaut, L.: Observations concernant l'hypertension chronique expérimentale du chien par constriction de l'artère rénale , Compt. rend. Soc. de biol. 123:1244 ( (Nov.) ) 1936. 9. (c) Page, I. H., and Sweet, J. E.: Extirpation of Pituitary Gland: Effect on Arterial Blood Pressure of Dogs with Experimental Hypertension , Proc. Soc. Exper. Biol. & Med. 34:260 ( (March) ) 1936. 10. (d) Blalock, A., and Levy, S. E.: Studies on the Etiology of Renal Hypertension , Ann. Surg. 106:826 ( (Nov.) ) 1937. 11. (e) Verney, E. B., and Vogt, M.: An Experimental Investigation into Hypertension of Renal Origin, with Some Observations on Convulsive "Uraemia," Quart. J. Exper. Physiol. 28:253 ( (Sept.) ) 1938. 12. (f) Fasciolo, J. C.; Houssay, B. A., and Taquini, A. C.: The Blood Pressure Raising Secretion of the Ischemic Kidney , J. Physiol. 94:281 ( (Dec.) ) 1938. 13. (g) Gibson, J. G., II., and Robinson, R. W.: Blood Volume, Cardiac Size and Renal Function in Dogs with Hypertension Produced by Goldblatt Technic , Proc. Soc. Exper. Biol. & Med. 39:497 ( (Dec.) ) 1938. 14. (h) Katz, L. N.; Friedman, M.; Rodbard, S., and Weinstein, W.: Observations on the Genesis of Renal Hypertension , Am. Heart J. 17:334 ( (March) ) 1939. 15. Löhlein, M.: Ueber Schrumpfnieren , Beitr. z. path. Anat. u. z. allg. Path. 63:570, 1917. 16. Longcope, W. T.: Chronic Bilateral Pyelonephritis: Its Origin and Its Association with Hypertension , Ann. Int. Med. 11:149 ( (July) ) 1937. 17. Weiss, S., and Parker, F., Jr.: Pyelonephritis: Its Relation to Vascular Lesions and to Arterial Hypertension , Medicine 18:221 ( (Sept.) ) 1939. 18. (a) Butler, A. M.: Chronic Pyelonephritis and Arterial Hypertension , J. Clin. Investigation 16:889 ( (Nov.) ) 1937. 19. (b) Barker, N. W., and Walters, W.: Hypertension Associated with Unilateral Chronic Atrophic Pyelonephritis: Treatment by Nephrectomy , Proc. Staff Meet., Mayo Clin. 13:118 ( (Feb. 23) ) 1938. 20. (c) Crabtree, E. G.: Hypertension in Destructive Infected Unilateral Lesions of the Kidney , Tr. Am. A. Genito-Urin. Surgeons 31:299 ( (May) ) 1938. 21. (d) Barney, J. D., and Suby, H. I.: Unilateral Renal Disease with Arterial Hypertension: Report of a Case Apparently Cured Following Nephrectomy , New England J. Med. 220:744 ( (May 4) ) 1939. 22. (e) McIntyre, D. W.: Unilateral Chronic Pyelonephritis with Arterial Hypertension , J. Urol. 41:900 ( (June) ) 1939. 23. (f) Nesbit, R. M., and Ratliff, R. K.: Hypertension Associated with Unilateral Nephropathy , J. Urol. 43:427 ( (March) ) 1940. 24. (g) Schroeder, H. A., and Fish, G. W.: Studies on "Essential" Hypertension: III. The Effect of Nephrectomy upon Hypertension Associated with Organic Renal Disease , Am. J. M. Sc. 199:601 ( (May) ) 1940.Crossref 25. (h) Braasch, W. F.; Walters, W., and Hammer, H. J.: Hypertension and the Surgical Kidney , J. A. M. A. 115:1837 ( (Nov. 30) ) 1940.Crossref 26. (i) Mulholland, S. W.: Hypertension's Challenge to Urology , J. Urol. 42:957 ( (Dec.) ) 1939. 27. (j) Engel, W. J.: Association of Unilateral Kidney Disease with Hypertension , Cleveland Clin. Quart. 7:290 ( (Oct.) ) 1940.Crossref 28. (k) Salley, S. M.: Hypertension Due to Unilateral Kidney Disease , Bull. Jackson Mem. Hosp. 3:10 ( (Jan.) ) 1941. 29. (l) Maher, C. C., and Wosika, P. H.: Urologic Hypertension: A Study of 101 Cases , J. Urol. 41:893 ( (June) ) 1939. 30. (m) Bothe, A. E.: Pyelonephritis in Children and Adults with Hypertension , J. Urol. 42:969 ( (Dec.) ) 1939 31. (n) Patch, F. S.; Rhea, L. J., and Codnere, J. T.: Hypertension in a Girl of Twelve, Associated with Unilateral, Chronic, Atrophic Pyelonephritis Treated by Nephrectomy , Canad. M. A. J. 43:419 ( (Nov.) ) 1940. 32. (o) Kennedy, R. L. J.; Barker, N. W., and Walters, W.: Malignant Hypertension in a Child: Cure Following Nephrectomy , Am. J. Dis. Child. 61:128 ( (Jan.) ) 1941.Crossref 33. (a) Moritz, A. R., and Oldt, M. R.: Arteriolar Sclerosis in Hypertensive and Non-Hypertensive Individuals , Am. J. Path. 13:679 ( (Sept.) ) 1937. 34. (b) Leadbetter, W. F., and Burkland, C. F.: Hypertension in Unilateral Renal Disease , J. Urol. 39:611 ( (May) ) 1938. 35. (c) Boyd, C. H., and Lewis, L. G.: Nephrectomy for Arterial Hypertension , J. Urol. 39:627 ( (May) ) 1938. 36. (d) Blackman, S. S., Jr.: Arteriosclerosis and Partial Obstruction of the Main Renal Arteries in Association with "Essential" Hypertension in Man , Bull. Johns Hopkins Hosp. 65:353 ( (June) ) 1939. 37. (e) Howard, T. L.; Forbes, R. P., and Lipscomb, W. R.: Aneurysm of the Left Renal Artery in a Child Five Years Old with Persistent Hypertension , J. Urol. 44:808 ( (Dec.) ) 1940. 38. (f) Saphir, O., and Ballinger, J.: Hypertension (Goldblatt) and Unilateral Malignant Nephrosclerosis , Arch. Int. Med. 66:541 ( (Sept.) ) 1940.Crossref 39. Pincoffs, M. C., and Bradley, J. E.: The Association of Adenosarcoma of the Kidney (Wilms' Tumor) with Arterial Hypertension , Tr. A. Am. Physicians 52:320, 1937. 40. Koons, K. M., and Ruch, M. K.: Hypertension in a Seven Year Old Girl with Wilms' Tumor Relieved by Nephrectomy , J. A. M. A. 115:1097 ( (Sept. 28) ) 1940.Crossref 41. B. S. Abeshouse ( Surgery 9:942 [ (June) ] 1941 42. 10:147 [July] 1941 43. Footnote 6. Footnote 7 b, c and e. 44. Footnote 6g, h, i and l. 45. Goldblatt (footnotes 1 and 2 c). 46. Goldblatt.2 Fasciolo and others.3f 47. Footnotes 1 and 2. 48. Goldblatt, H.: Studies on Experimental Hypertension: VII. The Production of the Malignant Phase of Hypertension , J. Exper. Med. 67:809 ( (May) ) 1938Crossref 49. Studies on Experimental Hypertension: XIII. Experimental Observations on the Malignant Phase of Essential Hypertension; the Production of Intrarenal and Extrarenal Arteriolar Necrosis and Necrotizing Arteriolitis , in Blood, Heart and Circulation , Publication 13, American Association for the Advancement of Science, New York, Science Press Printing Company, 1940, p. 266. 50. Rodbard, S., and Katz, L. N.: The Rôle of Renal Metabolism in Hypertension and Uremia , J. Exper. Med. 73:357 ( (March) ) 1941.Crossref 51. Page, I. H.: Newer Aspects of Experimental Hypertension , in Blood, Heart and Circulation , Publication 13, American Association for the Advancement of Science, New York, Science Press Printing Company, 1940, p. 239. 52. Blalock, A.: Experimental Hypertension , Physiol. Rev. 20:159 ( (April) ) 1940. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

STUDIES ON EXPERIMENTAL HYPERTENSION: XV. EXPERIMENTAL OBSERVATIONS ON HYPERTENSION ASSOCIATED WITH UNILATERAL RENAL DISEASE; EFFECT OF OCCLUSION OF THE URETER ON EXPERIMENTAL HYPERTENSION DUE TO UNILATERAL RENAL ISCHEMIA

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American Medical Association
Copyright
Copyright © 1941 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1941.01210150003001
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Abstract

Abstract In the earliest studies on experimental hypertension due to renal ischemia1 it was shown that constriction of the main artery of only one kidney in a dog or a monkey is sufficient to cause elevation of the blood pressure. It was also shown in these and in later studies2 that this elevation does not usually persist indefinitely unless the other kidney is removed or unless the main artery of the other kidney is also constricted. In most dogs with unilateral renal ischemia the blood pressure returns to the preoperative level in six weeks or less, but in some the hypertension may persist at a high level for many months. The return of the blood pressure to normal obviously may be due (a) to the development of considerable accessory circulation to the ischemic kidney or (b) to the compensating, neutralizing or inhibiting effect of the contralateral normal kidney. The References 1. (a) Goldblatt, H.; Lynch, J.; Hanzal, R. F., and Summerville, W. W.: Studies on Experimental Hypertension: I. The Production of Persistent Elevation of Systolic Blood Pressure by Means of Renal Ischemia , J. Exper. Med. 59:347 ( (March) ) 1934.Crossref 2. (b) Goldblatt, H.: Studies on Experimental Hypertension: III. The Production of Persistent Hypertension in Monkeys (Macaque) by Renal Ischemia , J. Exper. Med. 65:671 ( (May) ) 1937.Crossref 3. Goldblatt, H.: (a) Studies on Experimental Hypertension: V. The Pathogenesis of Experimental Hypertension Due to Renal Ischemia , Ann. Int. Med. 11:69 ( (July) ) 1937Crossref 4. (b) Experimental Hypertension Induced by Renal Ischemia , in Harvey Lectures, 1937-1938 , Baltimore, Williams & Wilkins Company, 1938, pp. 237-275 5. Bull. New York Acad. Med. 14:523 ( (Sept.) ) 1938 6. (c) Studies on Experimental Hypertension: XII. The Experimental Production and Pathogenesis of Hypertension Due to Renal Ischemia , Am. J. Clin. Path. 10:40 ( (Jan.) ) 1940. 7. (a) Wood, J. E., and Cash, J. R.: Experimental Hypertension: Observations on Sustained Elevation of Systolic and Diastolic Blood Pressure in Dogs , J. Clin. Investigation 15:543 ( (Sept.) ) 1936.Crossref 8. (b) Elaut, L.: Observations concernant l'hypertension chronique expérimentale du chien par constriction de l'artère rénale , Compt. rend. Soc. de biol. 123:1244 ( (Nov.) ) 1936. 9. (c) Page, I. H., and Sweet, J. E.: Extirpation of Pituitary Gland: Effect on Arterial Blood Pressure of Dogs with Experimental Hypertension , Proc. Soc. Exper. Biol. & Med. 34:260 ( (March) ) 1936. 10. (d) Blalock, A., and Levy, S. E.: Studies on the Etiology of Renal Hypertension , Ann. Surg. 106:826 ( (Nov.) ) 1937. 11. (e) Verney, E. B., and Vogt, M.: An Experimental Investigation into Hypertension of Renal Origin, with Some Observations on Convulsive "Uraemia," Quart. J. Exper. Physiol. 28:253 ( (Sept.) ) 1938. 12. (f) Fasciolo, J. C.; Houssay, B. A., and Taquini, A. C.: The Blood Pressure Raising Secretion of the Ischemic Kidney , J. Physiol. 94:281 ( (Dec.) ) 1938. 13. (g) Gibson, J. G., II., and Robinson, R. W.: Blood Volume, Cardiac Size and Renal Function in Dogs with Hypertension Produced by Goldblatt Technic , Proc. Soc. Exper. Biol. & Med. 39:497 ( (Dec.) ) 1938. 14. (h) Katz, L. N.; Friedman, M.; Rodbard, S., and Weinstein, W.: Observations on the Genesis of Renal Hypertension , Am. Heart J. 17:334 ( (March) ) 1939. 15. Löhlein, M.: Ueber Schrumpfnieren , Beitr. z. path. Anat. u. z. allg. Path. 63:570, 1917. 16. Longcope, W. T.: Chronic Bilateral Pyelonephritis: Its Origin and Its Association with Hypertension , Ann. Int. Med. 11:149 ( (July) ) 1937. 17. Weiss, S., and Parker, F., Jr.: Pyelonephritis: Its Relation to Vascular Lesions and to Arterial Hypertension , Medicine 18:221 ( (Sept.) ) 1939. 18. (a) Butler, A. M.: Chronic Pyelonephritis and Arterial Hypertension , J. Clin. Investigation 16:889 ( (Nov.) ) 1937. 19. (b) Barker, N. W., and Walters, W.: Hypertension Associated with Unilateral Chronic Atrophic Pyelonephritis: Treatment by Nephrectomy , Proc. Staff Meet., Mayo Clin. 13:118 ( (Feb. 23) ) 1938. 20. (c) Crabtree, E. G.: Hypertension in Destructive Infected Unilateral Lesions of the Kidney , Tr. Am. A. Genito-Urin. Surgeons 31:299 ( (May) ) 1938. 21. (d) Barney, J. D., and Suby, H. I.: Unilateral Renal Disease with Arterial Hypertension: Report of a Case Apparently Cured Following Nephrectomy , New England J. Med. 220:744 ( (May 4) ) 1939. 22. (e) McIntyre, D. W.: Unilateral Chronic Pyelonephritis with Arterial Hypertension , J. Urol. 41:900 ( (June) ) 1939. 23. (f) Nesbit, R. M., and Ratliff, R. K.: Hypertension Associated with Unilateral Nephropathy , J. Urol. 43:427 ( (March) ) 1940. 24. (g) Schroeder, H. A., and Fish, G. W.: Studies on "Essential" Hypertension: III. The Effect of Nephrectomy upon Hypertension Associated with Organic Renal Disease , Am. J. M. Sc. 199:601 ( (May) ) 1940.Crossref 25. (h) Braasch, W. F.; Walters, W., and Hammer, H. J.: Hypertension and the Surgical Kidney , J. A. M. A. 115:1837 ( (Nov. 30) ) 1940.Crossref 26. (i) Mulholland, S. W.: Hypertension's Challenge to Urology , J. Urol. 42:957 ( (Dec.) ) 1939. 27. (j) Engel, W. J.: Association of Unilateral Kidney Disease with Hypertension , Cleveland Clin. Quart. 7:290 ( (Oct.) ) 1940.Crossref 28. (k) Salley, S. M.: Hypertension Due to Unilateral Kidney Disease , Bull. Jackson Mem. Hosp. 3:10 ( (Jan.) ) 1941. 29. (l) Maher, C. C., and Wosika, P. H.: Urologic Hypertension: A Study of 101 Cases , J. Urol. 41:893 ( (June) ) 1939. 30. (m) Bothe, A. E.: Pyelonephritis in Children and Adults with Hypertension , J. Urol. 42:969 ( (Dec.) ) 1939 31. (n) Patch, F. S.; Rhea, L. J., and Codnere, J. T.: Hypertension in a Girl of Twelve, Associated with Unilateral, Chronic, Atrophic Pyelonephritis Treated by Nephrectomy , Canad. M. A. J. 43:419 ( (Nov.) ) 1940. 32. (o) Kennedy, R. L. J.; Barker, N. W., and Walters, W.: Malignant Hypertension in a Child: Cure Following Nephrectomy , Am. J. Dis. Child. 61:128 ( (Jan.) ) 1941.Crossref 33. (a) Moritz, A. R., and Oldt, M. R.: Arteriolar Sclerosis in Hypertensive and Non-Hypertensive Individuals , Am. J. Path. 13:679 ( (Sept.) ) 1937. 34. (b) Leadbetter, W. F., and Burkland, C. F.: Hypertension in Unilateral Renal Disease , J. Urol. 39:611 ( (May) ) 1938. 35. (c) Boyd, C. H., and Lewis, L. G.: Nephrectomy for Arterial Hypertension , J. Urol. 39:627 ( (May) ) 1938. 36. (d) Blackman, S. S., Jr.: Arteriosclerosis and Partial Obstruction of the Main Renal Arteries in Association with "Essential" Hypertension in Man , Bull. Johns Hopkins Hosp. 65:353 ( (June) ) 1939. 37. (e) Howard, T. L.; Forbes, R. P., and Lipscomb, W. R.: Aneurysm of the Left Renal Artery in a Child Five Years Old with Persistent Hypertension , J. Urol. 44:808 ( (Dec.) ) 1940. 38. (f) Saphir, O., and Ballinger, J.: Hypertension (Goldblatt) and Unilateral Malignant Nephrosclerosis , Arch. Int. Med. 66:541 ( (Sept.) ) 1940.Crossref 39. Pincoffs, M. C., and Bradley, J. E.: The Association of Adenosarcoma of the Kidney (Wilms' Tumor) with Arterial Hypertension , Tr. A. Am. Physicians 52:320, 1937. 40. Koons, K. M., and Ruch, M. K.: Hypertension in a Seven Year Old Girl with Wilms' Tumor Relieved by Nephrectomy , J. A. M. A. 115:1097 ( (Sept. 28) ) 1940.Crossref 41. B. S. Abeshouse ( Surgery 9:942 [ (June) ] 1941 42. 10:147 [July] 1941 43. Footnote 6. Footnote 7 b, c and e. 44. Footnote 6g, h, i and l. 45. Goldblatt (footnotes 1 and 2 c). 46. Goldblatt.2 Fasciolo and others.3f 47. Footnotes 1 and 2. 48. Goldblatt, H.: Studies on Experimental Hypertension: VII. The Production of the Malignant Phase of Hypertension , J. Exper. Med. 67:809 ( (May) ) 1938Crossref 49. Studies on Experimental Hypertension: XIII. Experimental Observations on the Malignant Phase of Essential Hypertension; the Production of Intrarenal and Extrarenal Arteriolar Necrosis and Necrotizing Arteriolitis , in Blood, Heart and Circulation , Publication 13, American Association for the Advancement of Science, New York, Science Press Printing Company, 1940, p. 266. 50. Rodbard, S., and Katz, L. N.: The Rôle of Renal Metabolism in Hypertension and Uremia , J. Exper. Med. 73:357 ( (March) ) 1941.Crossref 51. Page, I. H.: Newer Aspects of Experimental Hypertension , in Blood, Heart and Circulation , Publication 13, American Association for the Advancement of Science, New York, Science Press Printing Company, 1940, p. 239. 52. Blalock, A.: Experimental Hypertension , Physiol. Rev. 20:159 ( (April) ) 1940.

Journal

Archives of SurgeryAmerican Medical Association

Published: Sep 1, 1941

References