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TOTAL ADRENALECTOMY FOR MALIGNANT HYPERTENSION 1
Author(s) -
HANLEY HOWARD G.
Publication year - 1957
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1957.tb09363.x
Subject(s) - adrenalectomy , medicine , blood pressure , renal function , urea , urology , surgery , endocrinology , chemistry , organic chemistry
SUMMARY Summarising, it would seem that as a means of lowering blood‐pressure, adrenalectomy does not have much to offer, but as a means of keeping the patients alive in complete comfort it appears to be effective. Surgery of this nature should be considered as soon as malignant hypertension patients begin to show some diminution of renal function. It is well known that some patients can continue for many years in a state of essential hypertension, which quite suddenly may enter a malignant phase. If this is accompanied by a diminution in renal function, adrenalectomy may well offer the best chance of survival. In the same way cases of malignant hypertension which are controlled by hypotensive drugs may suddenly show a rise in blood urea. Again this is the time for adrenalectomy. It must be emphasised, however, that the figures for“normal”renal function vary with different individuals, so that an early rise in the blood urea or a fall in urea clearance can be detected only if a series of previous readings have been recorded; hence the importance of repeated renal function tests during the treatment of malignant hypertension with ganglion‐blocking agents. Only by accumulating more experience of this type of surgery will it be possible to compare our long‐term results with those of hypotensive drug therapy.