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Reassessment of Divided Renal Function Study in Prediction of Surgical Results in Renovascular Hypertension
Author(s) -
FOURNIER A.,
SAFAR M.,
VEILLON B.,
PAPANICOLAOU N.,
MILLIEZ P.
Publication year - 1973
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.1973.tb12171.x
Subject(s) - renovascular hypertension , renal function , medicine , nephrectomy , urology , creatinine , surgery , cardiology , kidney
Summary A retrospective analysis of 33 patients who had undergone nephrectomy or revascularisation procedures for renovascular hypertension was carried out in order to assess the value of divided renal function studies in the prediction of the results. The classical ischaemic criteria of Howard, Rapoport, and Guedon were proved to be in‐ sufficiently sensitive since, when they were not satisfied, surgery nevertheless improved hyper‐tension in 36 % to 60 % of cases. Our present experience leads us to recommend a single criterion of ischaemia‐an increase in urinary concentration of creatinine (ACr) of 20% or more on the diseased side (calculated by dividing the difference between the 2 kidneys by the concentration on the healthy side, not the diseased side as done by Howard). This single criterion has an excellent prognostic value (P <0.0001) with no false negative and only 11 % false positive results. In opposition to Stamey's proposals (1965), the additional requirement of a contralateral PAH clearance equal to or greater than 200 ml/minute does not increase, but decreases, the prognostic value of separated renal function studies. If our criterion is employed divided renal function tests can be considerably simplified. Infusion of PAH, urea and ADH are not required and only the simplest laboratory analyses are necessary.