Studies of the mechanism of contralateral polyuria after renal artery stenosis.

Galvez, Oscar G.; Roberts, Bertram W.; Mishkind, Michael H.; Bay, William H.; Ferris, Thomas F.

doi:10.1172/jci108678

Cited by 13 publications

(6 citation statements)

References 34 publications

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“…This notion was supported by the finding that the threshold concentration of angiotensin II needed to release prostaglandins from the kidney was in the range of that reported in patients with renovascular hypertension. 22 Further, Galvez et al 19 blocked the contralateral diuresis that follows ipsilateral arterial constriction with either angiotensin antagonists or blockers of prostaglandin synthesis. Thus, as hypertension progresses, ischemia in the stenotic kidney is diminished by a higher perfusion pressure, 23 rendering the stenotic kidney less dependent on synthesis of prostaglandins.…”

Section: Discussionmentioning

confidence: 99%

Effect of furosemide on renal function in the stenotic and contralateral kidneys of patients with renovascular hypertension.

Ruilope¹,

García-Robles²,

Sancho-Rof³

et al. 1983

Hypertension

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SUMMARY In a group of six patients diagnosed as having unilateral renovascular hypertension due to fibromuscular dysplasia, inulin glomerular filtration rate, (GFR) and PAH renal plasma flow, (RPF) clearances, urine flow (V), urine sodium (UV Nl ), potassium (UV K ), urinary excretion of prostaglandin E^ (UV reEj ), thromboxane B 2 (UV TxJ , 2 ), and 6-keto prostaglandin F la (UV^^) were measured in each kidney before and after the i.v. administration of furosemide (20 mg). The basal values of GFR, RPF, UV Ni , UVpc E ,, UV TlB ,, and UV 6 . krto . PCFla were lower (p < 0.01) in the stenotic kidney. Furosemide increased RPF 11 % and 50%, GFR 25% and 62%, and V 142% and 280% in the contralateral and stenotic kidney respectively. The increase of UV Na was similar in the two kidneys. In the stenotic kidney, both UVpcEj and UVj^^pcf^ increased significantly (p < 0.01) with furosemide while UV TlB , remained unchanged. Furosemide did not alter the rate of excretion of the three prostaglandins measured in the contralateral kidney. We conclude that furosemide significantly improves renal circulatory and excretory function of the stenotic kidney. Since prostaglandin excretions also increased, the vasodilatation in the stenotic kidney may be prostaglandin mediated. IT is known that the vasodilator action of furosemide in the normal kidney is mostly mediated by increased synthesis of prostaglandins, 1 " 4 which may also modulate the diuretic effects of furosemide. 4 Furosemide is currently used in patients with unilateral renovascular stenosis; however, it is not known whether its hemodynamic and diuretic effects are equally exerted or predominantly exerted in the stenotic kidney or in the contralateral kidney. Further, we have no knowledge about the changes induced by furosemide in prostaglandin synthesis in the stenotic and contralateral kidney. 56 In a recent survey of the literature, 7 there is convincing evidence supporting the notion that increased synthesis of prostaglandins is important inFrom the Departments of Nephrology and Endocrinology, 1st October and Ramon y Cajal Hospitals, Madrid, Spain, and from the Departments of Nephrology and Physiology, Mayo Clinic and Foundation, Rochester, Minnesota.Supported by Grant HL16496 from the National Institutes of Health, the National Heart, Lung and Blood Institute, and grants from the Mayo Foundation and the Spanish Ministry of Health (FIS Exp. 83/0575).Address for reprints: Dr. J.C. Romero, Department of Physiology, 9th Floor Guggenheim Building, Mayo Foundation, Rochester, Minnesota 55905. the maintenance of renal blood flow during the early phases of renovascular hypertension. However, in the chronic stages of hypertension, the role of prostaglandins has not been adequately explored. 7This study was undertaken to determine the effect of furosemide on renal hemodynamics, renal excretory function, and postaglandin excretion in both the stenotic apd contralateral kidneys of patients with renovascular hypertension. Materials and Methods Patient ProtocolThe study was co...

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Section: Discussionmentioning

confidence: 99%

Effect of furosemide on renal function in the stenotic and contralateral kidneys of patients with renovascular hypertension.

Ruilope¹,

García-Robles²,

Sancho-Rof³

et al. 1983

Hypertension

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“…This difference may be attributed to the earlier time at which we conducted our measurement. An increased urinary flow from the contralateral kidney was observed over a short period after renal artery stenosis by Galvez et al [15]. Also, DeForrest and co-workers studied separate renal functions in the two-kidney, one-clip hypertension model in dogs [16].…”

Section: Resultsmentioning

confidence: 95%

Time Course Study of Body Fluid Volumes in Two-Kidney, One-Clip and One-Kidney, One-Clip Hypertension in Rats

Yagi

Ichikawa

Sakamaki

et al. 1987

J. Clin. Biochem. Nutr.

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SummaryTime related changes in distributions of body fluid volumes were studied in rats with either of two types of Goldblatt hypertension; two-kidney, one-clip (2K1C) and one-kidney, one-clip (1K1C) models. Plasma volume (PV), extracellular fluid volume (ECF), and total body water (TBW) were measured on days 1, 7, and 28 after renal artery stenosis. Mean arterial pressure (MAP) and plasma renin activity (PRA) were also determined in conscious rats.In the 2K1C rats each fluid compartment on any experimental day did not differ from the sham controls except for a decrease in PV of the clipped rats on day 1. MAP in the 2K1C increased significantly (p<0.05) only on day 28 as compared with the controls. In the 1 K1 C rats the tendency toward an increase in PV and ECF on early days was followed by a significant (p <0.05) elevation in ECF on day 28. MAP was higher in the clipped rats than in the controls on days 7 and 28. There were no differences in PRA between the clipped rats and the controls either in 2K1C or 1K1C throughout the study.These results suggest that alterations of body fluid volumes might be involved in the development and maintenance of hypertension in the 1K1C rats, but not in the 2K1C ones. In contrast, the role of the reninangiotensin system was rather negligible in these two models, as judged from the PRA levels.

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“…HHS is more frequently reported in patients with unilateral RAS. In patients with unilateral RAS corresponding to the 2-kidney-1-clip hypertension model [7], sustained renin secretion of the stenotic kidney with low perfusion and pressure natriuresis of the contralateral kidney are the main mechanisms to HHS development [4]. In the study by Agarwal et al [4], HHS was also reported in association with bilateral RAS in some patients.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Transluminal Revascularization following an Angiotensin Receptor Blocker: Successful Treatment for Flash Pulmonary Edema and Hyponatremic Hypertensive Syndrome

Shao

Gao²,

Xu³

et al. 2012

Cardiorenal Med

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Either flash pulmonary edema or hyponatremic hypertensive syndrome has been described in renal artery stenosis. However, coexistence of these two disorders has never been previously reported. We describe a patient who presented with flash pulmonary edema and hyponatremic hypertensive syndrome associated with bilateral renal artery disease (one complete occlusion, one highly critical renal artery stenosis, the equivalent of unilateral stenosis of a solitary functioning kidney). His blood pressure, hyponatremia, and symptoms of acute heart failure were much improved by an angiotensin receptor blocker. After the procedure of percutaneous transluminal revascularization, his stenotic kidney function and serum sodium levels were completely restored.

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Studies of the mechanism of contralateral polyuria after renal artery stenosis.

Cited by 13 publications

References 34 publications

Effect of furosemide on renal function in the stenotic and contralateral kidneys of patients with renovascular hypertension.

Effect of furosemide on renal function in the stenotic and contralateral kidneys of patients with renovascular hypertension.

Time Course Study of Body Fluid Volumes in Two-Kidney, One-Clip and One-Kidney, One-Clip Hypertension in Rats

Percutaneous Transluminal Revascularization following an Angiotensin Receptor Blocker: Successful Treatment for Flash Pulmonary Edema and Hyponatremic Hypertensive Syndrome

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