25 hypertensive patients were examined by aortography and bilateral selective renal arteriography. Before angiographies, the following investigations were done: rapid-sequence intravenous urography, isotopic renogram, and renal scintigraphy. All the patients had essential arterial hypertension, except 1 with primary aldosteronism. In 11 patients renal-arteriogram abnormalities were asymmetrical (dominant in one kidney, or else visible in one of them in a diffuse or segmentary way only) and affected the interlobar and arcuate arteries (asymmetric interlobar nephrosclerosis); in 9 of them the earlier investigations had revealed morphological or/and functional asymmetry in accord with the arteriograms. The more affected kidney, from the vascular point of view, was the left one in 10 out of 11 cases. Biopsy of the more injured kidney, in 6 cases, showed arteriolar sclerosis. In 2 patients with asymmetric interlobar nephrosclerosis the renal-vein renin was measured: in one of them the renal-vein-renin ratio was much higher than 1.5 and the renin release from the kidney with less arterial injury was suppressed. From all this information one can conclude that interlobar nephrosclerosis is often asymmetrical. In some cases the more injured kidney could worsen or induce hypertension. The asymmetrical arterial abnormalities seen in the investigations done before arteriography could mistakenly have suggested stenosis of the main renal artery or of its first branches: the arteriographic finding of abnormalities in only one kidney make one think of an unilateral nephropathy. © 1974.
|Publication status||Published - 30 Mar 1974|