Thromboendarterectomy for Hypertension Due to Renal Artery Occlusion

Freeman, Norman E.; Leeds, Frank H.; Elliott, Wallace G.; Roland, Samuel I.

doi:10.1001/jama.1954.02950110039012

Cited by 107 publications

(10 citation statements)

References 5 publications

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“…How ever, in some of our patients without malignant hyper tension the magnitude of the proteinuria was in excess of the levels previously reported and was sometimes in the frankly nephrotic range. Nephrotic range proteinuria has been previously described in association with renal artery stenosis [15][16][17][18], where it decreased markedly following uninephrcclomy [17,18] or surgical repair of the affected vessel [15], Only 1 of our patients had renal artery steno sis and malignant hypertension. Although arteriography was not done in all patients, and hence renal artery steno sis can not be ruled out with absolute certainty, no evi dence for its presence was uncovered by clinical or other noninvasive radiographic studies (intravenous pyelogra phy and renal isotope scan).…”

Section: Discussionmentioning

confidence: 49%

Marked Proteinuria in Hypertensive Nephrosclerosis

et al. 1985

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Heavy proteinuria in patients with essential hypertension raises the question of underlying primary renal disease. While malignant hypertension may be associated with proteinuria in the nephrotic range, it is generally held that protein excretion in benign nephrosclerosis is almost invariably less than 0.5–1.0 g/24 h. We report 18 patients with biopsy-proven hypertensive nephropathy and heavy proteinuria, of which only 6 had malignant hypertension. In the remaining 12 patients with benign nephrosclerosis, protein excretion reached up to 6.5 g/24 h, and nephrotic range proteinuria was present in 3 patients. All patients with heavy proteinuria suffered from long-standing moderate or severe, poorly controlled hypertension and were azotemic. We suggest that hypertensive nephrosclerosis be included in the differential diagnosis of massive proteinuria accompanying azotemia in poorly controlled hypertensives.

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Section: Discussionmentioning

confidence: 49%

Marked Proteinuria in Hypertensive Nephrosclerosis

et al. 1985

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“…In some cases a marked decrease in proteinuria has occurred when the renal artery stenosis was treated by nephrectomy [2] or surgical repair of the affected vessel [3].…”

Section: Introductionmentioning

confidence: 99%

Reversible Nephrotic Range Proteinuria with Renal Artery Stenosis: A Clinical Example of Renin-Associated Proteinuria

Eiser

Katz

Swartz³

1982

Nephron

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Nephrotic range proteinuria occurred in a 60-year-old woman with renal artery stenosis and marked hyperreninemia. Treatment by nephrectomy produced resolution of both proteinuria and hypertension. The gradual resolution of the proteinuria postoperatively suggested the proteinuria, at least in part, came from the contralateral kidney. Foot process fusion in the nephrectomy specimen suggested it too was a source of proteinuria. A marked degree of hyperreninemia, as was present in this case, may be necessary before massive proteinuria occurs in renal artery stenosis.

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“…cure of hypertension after surgical revascularization was followed with enthusiasm for renal artery repair. 1 When surgery was applied indiscriminately, however, the surgical correction of ASO-RVD was associated with a beneficial blood pressure response in less than half of the patients who underwent operation. 2,3 These surgical results fostered pessimism regarding the value of the operative repair of ASO-RVD for the treatment of hypertension.…”

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confidence: 99%