The diagnosis and treatment of renal hypertension

Diagnosis and Treatment of Renal-artery Stenosis

“…Only in this way can accurate measurements of urine flow and clearances be made. There is evidence (Levinsky and Berliner, 1959;Yendt et al, 1960) that movements of water and electrolytes can take place across the walls of the ureter and bladder, and our experience confirms that calculations of the amount of 'eakage from either side based upon the relative concentrations of electrolytes in the ureteric samples and in the bladder are unre!iable. Investigations where only one ureter is catheterized, the bladder urine being assumed to come entirely from the opposite side, are also open to question.…”

“…Where bilateral renal-artery stenosis is present, particularly good contrast might be expected on excretion urography. The case described by Yendt et al (1960) appears to be an example of this phenomenon.…”

“…Several authors have commented on the preservation of the excretion pyelogram of a kidney with a stenosed artery, though the fact that better contrast may often be seen on this side seems to have passed unnoticed (DeCamp and Page et al, 1959;Squire and Schlegel, 1959;Yendt et al, 1960). In consequence, the tendency has been to overstress the limitations of this technique.…”

“…Surgical Procedures Surgical procedures have been described by Poutasse (1956), DeCamp and Birchall (1958), Owen (1959Owen ( , 1960, and Yendt et al (1960).…”

The Excretion of Acid in Unilateral Renal Disease in Man*

“…To overcome such limitations, Morrin, Bricker, Kime, and Klein (6) employed an experimental model of unilateral disease in the dog that allowed examination of the diseased kidney in the same milieu as the normal kidney. In man, except for a few observations in renal arterial stenosis (7)(8)(9)(10), the acidifying capacity of the diseased kidney has not been studied in a comparable way.…”