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

据推测，半肾切除的受试者容易发生高血压。然而，高血压的真实发病情况尚不清楚，其发病机制尚不清楚。在这项研究中，研究了半肾切除后高血压的发生频率，并对人和大鼠的高血压机制进行了研究。在34名三年前行半肾切除的受试者的人类研究中，有17名受试者(50%)的血压超过160毫米汞柱和95毫米汞柱。高血压组肾功能较非高血压组肾功能下降更明显。半肾切除的原因似乎也与高血压的发生频率有关，因为它的频率似乎更多地出现在被认为剩余肾脏因某些疾病损害的患者中。在半肾切除的受试者中，尿激肽释放酶的排泄量显著减少，但尚不清楚它的减少是否在高血压的发生中起重要作用。在动物研究中，体重350-360克的大鼠比体重140-150克的大鼠更容易发生高血压。还发现，由于钠负荷加速了高血压的发展，超出排泄功能的盐负荷似乎是重要的。从这些研究表明，高血压在半肾切除的受试者中容易发生，可能是由于排泄功能有限。其中剩余肾脏的代偿功能可能起重要作用。

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.