高血壓と腎機能(第5報) : 臨床的研究 : 腎性高血壓症及び内分泌性高血壓症

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The purpose of these clinical studies is to examine whether the conclusion attained from my experimental studies mentioned above can be applied to the following clinical cases : 1) Renal hypertension 2) Endocrine hypertension 3) Neurogenic hypertension 4) Essential hypertension 5) ATP-ATPase system I) RENAL HYPERTENSION a) Acute glomerulonephritis : 9 cases of acute glomerulonephritis were observed. RBF was ranged within 515-1178 cc/min., averaged 793 cc/min., GFR was ranged within 30.6-119,averaged 69.8 cc/min., and FF was ranged within 0.067-0.219,averaged 0.140. With recovery, GFR, RBF and FF rised to normal level, sometimes slowly or sometimes rapidly. In general, at the age after puberty, recovery is apt to be late. In adults, FF is sometimes left at lower level for one or two years in spite of complete recovery of clinical symptoms.Recovery or failure of recovery from acute glomerulonephritis is not always correlated with the digree of renal functional damage. But in cases with markedly reduced RBF in acute stage, complete recovery is not always obtained.b) Chronic glomerulonephritis : 59 patients were studied and they were divided into 4 groups.In latent type, RBF was ranged within 590-2100 cc/min., averaged 942 cc/min., GFR was ranged within 79-146,averaged 106 cc/min. and FF was ranged within 0.128-0.268,averaged 0.202. Tm_<PAH> was 73 mg/min., RPF/Tm_<PAH> 6.08 and GFR/Tm_<PAH> 1.55.In hypertensive type (not including terminal stage), RBF was ranged within 101-1724,averaged 805 cc/min., GFR was ranged within 12-190,averaged 83 cc/min. and FF was ranged 0.122-0.279,averaged 0.192.In nephrotic type, RBF was ranged within 117-1476,averaged 562 cc/min., GFR was ranged 14-155,averaged 72 cc/min. and FF was ranged within 0.091-0.465,averaged 0.217. Tm_<PAH> was ranged within 21-106,averaged 60 mg/min. and Tm_G was ranged within 341-625,averaged 479 mg/min. RPF/Tm_<PAH> was averaged 6.02,GFR/Tm_<PAH> 1.53,RPF/Tm_G 1.05 and GFR/Tm_G 0.245.In terminal stage, RBF was ranged within 8.2-118,averaged 50.9 cc/min., GFR was ranged within 1.8-28.2,averaged 10.0 cc/min. and FF was ranged within 0.132-0.806,averaged 0.308. Tm_<PAH> was ranged within 4.2-14.4,averaged 7.5 mg/min., Tm_G was ranged 30.3-35.9,averaged 33.1 mg/min. RPF/Tm_<PAH> was averaged 5.02,GFR/Tm_<PAH> 1.27,RPF/Tm_G 0.93 and GFR/Tm_G 0.251.It is not surprised that, in glomerulonephritis, the ratio GFR/Tm is below normal, but the fact that, according to my data of chronic glomerulonephritis, RPF/Tm is below normal value suggests the possibility to produce elevation of blood pressure.And I stated the possibility of post-infections hypertension, which was occurred after virus infection (common cold, influenza etc.) and was protein-uria-free ; Glomerulonephritiden ohne krankhaften Harnbefund nach Arnord?Besides the glomerulonephritis, urethral constriction with hydronephrosis, polycystic kidneys, chronic pyelonephritis, Buerger's disease with renal arterial stenosis (Goldblatt's type), kidney tumor (Wilm's tumor) and intercapillary glomerulosclerosis were studied.In intercapillary glomerulosclerosis, pattern of renal functions was similar to advanced form of glomerulonephritis. In hypertension with urethral constriction, blood pressure was reduced after urethral bouginage and also in hypertension with Wilms' tumor after nephrectomy it was the same manner.II) ENDOCRINE HYPERTENSION In each case with Cushing's syndrome and with achromegaly, RBF was found to be below the mean normal value, but FF above the normal, simulating the typical pattern of essential hypertension.20 patients with diabetes mellitus was studies. 6 cases of them (30%) were hypertensive. The renal functions were found to be widely variable and average RBF was 872 cc/min., but in cases with complications, it was lower.
社団法人日本循環器学会の論文
1958-05-20

高血壓と腎機能(第5報) : 臨床的研究 : 腎性高血壓症及び内分泌性高血壓症

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