Critical perfusion pressure for renal function in patients with bilateral atherosclerotic renal vascular disease.

Abstract:

:We studied renal plasma flow and glomerular filtration rate during graded blood pressure reduction induced with sodium nitroprusside infusion in 16 hypertensive patients with atherosclerotic renovascular disease. Eight patients with unilateral disease tolerated pressure reduction from 205 +/- 9 (SE)/103 +/- 2 mm Hg to 146 +/- 6/84 +/- 3 mm Hg (p less than 0.01) with no change in total renal function. In 8 other patients with bilateral renal arterial stenosis (all arteries 70% or more stenosed), similar pressure reduction produced marked but reversible decrements in plasma flow (152 +/- 28 mL/min to 66 +/- 13 mL/min; p less than 0.01) and glomerular filtration rate (38 +/- 8 mL/min to 16 +/- mL/min; p less than 0.01). In 4 patients restudied after revascularization, sensitivity of renal function to pressure changes was no longer present. These data indicate that vascular stenosis to the entire renal mass may limit function and provide a means for evaluating patients at risk for loss of renal function during antihypertensive therapy.

journal_name

Ann Intern Med

authors

Textor SC,Novick AC,Tarazi RC,Klimas V,Vidt DG,Pohl M

doi

10.7326/0003-4819-102-3-308

subject

Has Abstract

pub_date

1985-03-01 00:00:00

pages

308-14

issue

3

eissn

0003-4819

issn

1539-3704

journal_volume

102

pub_type

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