STUDIES ON THE INCIDENCE AND MECHANISM OF HYPERTENSION IN HEMI-NEPHRECTOMIZED SUBJECTS.

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It is supposed that hypertension develops easily in hemi-nephrectomized subjects. However, the real incidence of the hypertension is obscure and its mechanism is still unknown. In this study it was investigated how often hypertension develops after hemi-nephrectomy, and the mechanism of hypertension was examined in man and rats.In human study using 34 subjects in which hemi-nephrectomy was done more than 3 years ago, hypertension over 160 mmHg systolic and 95 mmHg diastolic was observed in 17 of 34 subjects (50%). In those subjects with hypertension, renal function was more reduced than that in the subjects without hypertension. The causes of hemi-nephrectomy also seemed to be related to the frequency of the development of hypertension, since its frequency seemed to be more often in patients in whom the remaining kidney was supposed to be damaged by some diseases. Urinary excretion of kallikrein was markedly reduced in the hemi-nephrectomized subjects, but it was not clear whether its reduction may play an important role in the development of hypertension.In animal study, development of hypertension was more frequent when hemi-nephrectomy was done in rats weighing 350-360 g than when it was done in rats weighing 140-150 g. It was also found that overloading of salt beyond excretory function seems to be important, since development of hypertension was accelerated by sodium loading.From these studies it was suggested that hypertension develops easily in hemi-nephrectomized subjects, probably due to limited excretory function, in which the compensatory function of the remaining kidney may play an important role.