老年高血圧者腎の機能像および組織像にかんする研究
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概要
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The author studies the relationship between the blood pressure and the pathological changes of the kidney in aged persons above 60 years refering to renal clearance test, retinoscopy, auto sy and biopsy findings of the kidney.(1) About a half of 1162 aged persons examined showed hypertension above 160mmHg in systolic pressure and above 90mmHg in diastolic pressure, and systolic hypertension increased in number with the advance of the age, and in general the blood pressure is higher in the female than in the male.(2) Renal clearance studies (79 cases): 1) Even among normotensive persons, fifty percent of them showed low RPF values below 350cc/min. 2) Among the hypertensives the percentage of persons with RPF below 350cc/min increased more paralleling to the diastolic pressure than to the systolic pressure. 3) Average value of FF of normotensive persons was 0.27 and that of hypertensive persons was 0.28, therefore FF values of the aged were higher than the average of essential hypertensive persons counting 0.26. 4) The death rate of the persons whose RPF abnormally decreased is far higher than that of the persons whose RPF is normal. The remainder of the life of the aged persons with decreased RPF tends to be shortened.(3) Retinal findings (121 cases): Almost all of the aged persons showed to some extent retinal sclerosis, but advanced retinosclerosis at the grade of IV following Keith-Wageners classification was rare.(4) Autopsy findings of the kidney: The pathological findings of kidneys of aged could be classified into three types: Arteriolosclerotic nephrosclerosis, arteriosclerotic nephrosclerosis and chronic nephritis.(5) Kidney biopsy: The needle biopsy was performed in each of the three types mentioned above, and their histological findings were the same with that of autopsy.(6) It is important for the clinical management of the hypertension of the aged to classify it so far as possible into three types mentioned above and the criteria of classification should be given by clinical picture, the retincscopical findings and renal clearance tests.
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