慢性糸球体腎炎における高血圧の成因に関する研究 ―特に血漿レニン活性, 体液量ならびにNa代謝の面からー
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In order to investigate the mechanism of hypertension associated with chronic glomerulonephritis (CGN), plasma renin activity (PRA), plasma volume (PV), extracellular fluid volume (ECFV) and total exchangeable sodium (Nae) were measured in 15 normotensive and 22 hypertensive patients with CGN, and correlation if any, of parameters of the above items with the mean arterial pressure (MAP) or renal function was observed. In addition, the relationship between MAP and renal function was analyzed. 1) In 9 out of 22 hypertensive patients, PRA was in excess of the normal range, while in all but one, normotensives showed normal values, while it was noted that PRA tended to be higher in the former than the latter. PV was significantly higher in the hypertensives, although it was within a normal range in all patients. In all of the normotensive, ECFV and Nae were in a normal range, while the values in some of the hypertensives were higher. ECFV was significantly higher and Nae tended to be higher in the hypertensives than in normotensives. 2) A significantly positive correlation between MAP and PRA, PV, ECFV or Nae was in evidence. 3) MAP was found to be positively correlated with blood urea nitrogen (BUN) and negatively with creatinine clearance (C. creat.), excretion rate of phenolsulfonphthalein at 15 minutes (PSP) and maximum specific gravity of the urine was seen by the Fishberg concentration test (Urinary conc.). 4) PRA tended to be higher in patients with renal dysfunction, but no correlation between PRA and renal function was seen. PV and ECFV were positively correlated with BUN and negatively with C. creat., PSP and Urinary conc.. In addition, PV was correlated to the hemoglobin value. In contrast, Nae showed no correlation with the renal function. 5) In the patients in whom serum creatinine level was below 3 mg/d?, a comparison of PRA, PV, ECFV and Nae was run between normotensives and hypertensives. Although no significant difference of PRA and PV between two groups was seen, many patients with high MAP showed higher values of PRA and PV. ECFV tended to be higher in hypertensives as compared with normotensives, and a significantly positive correlation with MAP was noted. Nae was slightly higher in the hypertensives, and it tended to be positively correlated with MAP. These results indicate that both PRA and body fluid volume play an important role in the elevation of blood pressure in CGN and it was suggested that a disturbed feed back mechanism between PRA and body fluid volume due to renal dysfunction may be involved in the mechanism of hypertension.
- 札幌医科大学の論文
- 1977-02-01
札幌医科大学 | 論文
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