Critical perfusion pressure for renal function in patients with bilateral atherosclerotic renal vascular disease

S. C. Textor, A. C. Novick, R. C. Tarazi, V. Klimas, D. G. Vidt, M. Pohl

Research output: Contribution to journalArticle

98 Scopus citations

Abstract

We studied renal plasma flow and glomerular filtration rate during graded blood pressure reduction induced with sodium nitroprusside infusion in 16 hypertensive patients with atherosclerotic renovascular disease. Eight patients with unilateral disease tolerated pressure reduction from 205 ± 9 (SE)/103 ± 2 mm Hg to 146 ± 6/84 ± 3 mm Hg (p < 0.01) with no change in total renal function. In 8 other patients with bilateral renal arterial stenosis (all arteries 70% of more stenosed), similar pressure reduction produced marked but reversible decrements in plasma flow (152 ± 28 mL/min to 66 ± 13 mL/min; p < 0.01) and glomerular filtration rate (38 ± 8 mL/min to 16 ± mL/min; p < 0.01). In 4 patients restudied after revascularization, sensitivity of renal function to pressure changes was no longer present. These data indicate that vascular stenosis to the entire renal mass may limit function and provide a means for evaluating patients at risk for loss of renal function during antihypertensive therapy.

Original languageEnglish (US)
Pages (from-to)308-313
Number of pages6
JournalAnnals of internal medicine
Volume102
Issue number3
DOIs
StatePublished - Jan 1 1985

ASJC Scopus subject areas

  • Internal Medicine

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