PLASMA-RENIN ACTIVITY IN RENAL-TRANSPLANT PATIENTS WITH HYPERTENSION

被引：20

作者：

BRESTICKER, M ^{[1
]}

NELSON, J ^{[1
]}

HUANG, C ^{[1
]}

WOLF, J ^{[1
]}

ANDERSON, B ^{[1
]}

机构：

[1] NORTHWESTERN UNIV,SCH MED,DEPT SURG,250 E SUPER ST,CHICAGO,IL 60611

来源：

AMERICAN JOURNAL OF HYPERTENSION | 1991年 / 4卷 / 07期

关键词：

RENAL TRANSPLANT; HYPERTENSION; RENIN;

D O I：

10.1093/ajh/4.7.623

中图分类号：

R6 [外科学];

学科分类号：

1002 ; 100210 ;

摘要：

Chronic renal allograft rejection (CR) is the major cause of graft loss after 1 year following transplantation. Hypertension (HTN) and proteinuria (U(p)) are the hallmarks of this immunologic allograft response. Over 1 year, 23 patients posttransplantation and with HTN (diastolic greater than 95 mm Hg) were examined. Serial serum creatinine (S(cr)), U(p), urine creatinine (U(cr)), and resting and enalapril challenged (EC) plasma renin activity (PRA) were all determined. Renal artery stenosis was excluded by noninvasive imaging. Of the 23 patients, eight eventually lost their renal allografts, while 15 maintained satisfactory renal function (S(cr) less than 2.5). Results of this study show that: 1) worsening renal function (RF) increases EC reactivity; 2) the presence of proteinuria is not itself related to increase in EC activity; 3) renin before and after EC was higher (P = .06) in the allograft loss group. In this study, patients with high PRA represent the highest EC responses. Therefore, they display not macrovascular lesions, but microvascular intrarenal disease; this defect is most likely secondary to chronic immunologic insult.

引用

页码：623 / 626

页数：4

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