Pyelonephritis and Hypertension

Abstract

Blood pressure changes were followed up for 1-12 years (average; 3.8 years) in 46 cases of confirmed postoperative chronic pyelonephritis which had undergone ureterocutaneostomy, nephrostomy or other urologic operations.Diastolic blood pressure levels averaged 82 mmHg before operation, and 89 mmHg in the chronic stage after the operation. The incidence of hypertension (over 100 mmHg diastolic pressure) was 7% before the operation, but rose to 30% in the chronic stage. Application of an "age and sex-adjusted score" also served to confirm a mean increase in blood pressure through the development of chronic pyelonephritis.No correlation was found between renal function and blood pressure.Nor was there any definite relationship between family history of hypertension and high blood pressure.In the 14 cases observed for plasma renin activity, values were found to be in the normal range.pyelonephritis; hypertension; postoperative hypertensionThe relationship between chronic pyelonephritis and hypertension has been widely studied since it was first pointed out by Longcope (1937). There remains a problem, however, as to the cause-and-effect relationship between the two diseases. This may be because blood pressure has been observed in cases of pyelonephritis only after the onset of the chronic stage, and without reference to pre-disease levels. Further, when observations were made over a long period of time, age-related rises in blood pressure may over-lap. A comparative study of blood pressure levels before and after the development of pyelonephritis should help to clarify the relationship between the two diseases.We examined 46 patients who had developed chronic non-obstructive pyelone phritis after undergone urologic operation. Controls were provided by blood pressure measurements in other urological cases free from pyelonephritis and renovascular hypertension. For the cases of chronic pyelonephritis the relationships between blood pressure and renal function, and between blood pressure and genetic factor were also assessed. In 14 of these cases plasma renin activity was also studied in related to blood pressure.