Renal Venous Renin Ratio as a Predictor of Improvement in Hypertension Following Nephrectomy for Unilateral Renal Disease

Abstract

Renal venous renin ratio (RVRR) was measured in twenty hypertensive patients before removal of a kidney for unilateral, parenchymal renal disease. They were then followed for 1.3-9 y. Hypertension was cured or improved in six of eight patients with positive unstimulated and stimulated ratios, in none of five whose ratios became positive only on stimulation, and in one of seven with all ratios negative. Patients improved or cured by surgery had a significantly shorter duration of hypertension and a significantly lower serum creatinine after nephrectomy. Unstimulated RVRR was a reliable predictor of the effect of unilateral nephrectomy on blood pressure level.

The utility of renal venous renin studies in selection of patients with renal artery stenosis for angioplasty

“…To date, results have been conflicting as to the usefulness of RVRs, which have appeared to better differentiate patients who might benefit from nephrectomy rather than those who benefit from angioplasty [7,8]. However, the clinical protocols for RVRs have varied widely among these studies, including the degree to which factors (such as medications, dietary salt intake and posture) that affect renin levels are regulated, and whether samples are collected following stimulation of renin release by administration of an angiotensin-converting enzyme inhibitor (which has been shown to improve sensitivity of RVRs in detecting unilateral renin hypersecretion) [7][8][9][10][11].…”