The Effect of Renal Denervation on Patients Suffering From Nephritis 1

Abstract

Jaboulay(1) appears to have been the first to perform the operation of periarterial neurectomy in man. The procedure, however, did not achieve popularity until after the appearance of a series of papers by Leriche and his associates (2, 3). The effect on patients suffering from peripheral vascular disease has been especially extensively investigated. Denervation of the kidneys more recently has been performed on patients suffering from nephralgia and hydronephrosis, success being achieved in the relief of pain. ANATO M ICALThe renal nervre supply is derived mainly from the celiac ganglia with small branches from the plexuses around the adrenal gland and the aorta.Usually one branch comes from the splanchnic nerves direct. Through the celiac ganglion the renal nerves are brought into connection with the splanchnic nerves and with the vagus. The vagus nerve also sometimes-sends a direct branch to the kidneys. A few branches are received from the superior mesenteric ganglion.It has long been recognized that the splanchnic nerves form the chief vasomotor supply of the kidneys. Bradford (4) found that stimulation of the anterior roots of the cord from the sixth thoracic to the second lumbar segment caused the kidneys to constrict. Of these roots the tenth to twelfth dorsal were most effective. Vasodilator fibers were also present but were weak in comparison with the constrictors.Langley and Anderson (5), Jost (6), and Hirt (7) have clearly demonstrated fibers coursing from the third, fourth, and fifth lumbar ganglia to join the renal plexus. Most of the nerves are non-medullated, but some in the plexus are myelinated (Renner (8)). Ganglion cells which are

The Effect on the Kidney of Bilateral Splanchnicectomy in Patients With Hypertension

“…We are at present unable to predict or account for these differences. Contrary to the findings of Page and Heuer (9), however, we find a definite association between changes in renal function and in blood pressure in most patients. Certainly, renal disease with marked impairment of function may accompany hypertensive vascular disease, and when present, disappears following relief of the hypertension by splanchnicectomy.…”

“…In some cases we have observed, as have Page and Heuer (9), an improvement in proteinuria and hematuria, out of all proportion to changes in renal function.…”

“…Certainly, renal disease with marked impairment of function may accompany hypertensive vascular disease, and when present, disappears following relief of the hypertension by splanchnicectomy. 1 Page and Heuer (9) found an increase in concentrating ability in 2 of 5 patients with nephritis whose kidneys were denervated, but found no alteration in urea clearance.…”

The Influence of High and Low Fat Diets and Thyroid Substance on Plasma Lipids of Nephrotic Patients

“…Bilateral renal denervation was performed. The results of this operation were reported elsewhere by Page and Heuer (32).…”

Novel Approaches in Hypertension Treatment - Modulation of the Sympathetic Overactivity

“…In 1923, sympathectomy was performed for the first time in order to treat hypertension with stenocardia [72]. In 1935, Page and Heuer at the Rockefeller institute published data on surgical sympathectomy on blood pressure and renal function [73]. In 1953, a large study of 1266 cases was published on lumbal sympathectomy.…”