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

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

Research output: Contribution to journalArticle

98 Citations (Scopus)

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
StatePublished - 1985
Externally publishedYes

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Vascular Diseases
Perfusion
Kidney
Pressure
Glomerular Filtration Rate
Pathologic Constriction
Renal Plasma Flow
Nitroprusside
Antihypertensive Agents
Blood Vessels
Arteries
Blood Pressure
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Critical perfusion pressure for renal function in patients with bilateral atherosclerotic renal vascular disease. / Textor, Stephen C; Novick, A. C.; Tarazi, R. C.; Klimas, V.; Vidt, D. G.; Pohl, M.

In: Annals of Internal Medicine, Vol. 102, No. 3, 1985, p. 308-313.

Research output: Contribution to journalArticle

Textor, Stephen C ; Novick, A. C. ; Tarazi, R. C. ; Klimas, V. ; Vidt, D. G. ; Pohl, M. / Critical perfusion pressure for renal function in patients with bilateral atherosclerotic renal vascular disease. In: Annals of Internal Medicine. 1985 ; Vol. 102, No. 3. pp. 308-313.
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