Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Hypertension and renovascular disease: follow-up on 100 renal vein renin samplings

Journal of Human Hypertension volume 16, pages 275–280 (2002)Cite this article

Abstract

The clinical value of renal vein renin sampling (RVRS) as a prognostic tool in the treatment of renovascular hypertension was evaluated. One hundred consecutive patients were included over a 4-year period of time. About half of the patients (49%) were treated interventionally by PTRA (21%), nephrectomy (20%), or vascular surgery (8%). Seven patients (15%) were cured and 15 (32%) had improved (reduction in antihypertensive medicine) after 6 months follow-up, whereas three patients (6%) were cured and 12 (26%) improved after 3–4 years follow-up. Thus, the number of patients cured or improved is comparable with the results from our department reported 20 years ago. However, in the present report, more than twice as many patients were enrolled, leading to double costs. Different indices of lateralisation of the renin generation were calculated for the use in cases of a shrunken kidney (functional share ⩽15%). None of the indices clearly discriminated between the patients who did benefit from intervention, and those who did not. The only positive finding was that a peripheral renin concentration lower than 8 mlU/l predicted no effect of intervention, which might lead to the exclusion of 11% of the patients before entering the diagnostic programme. We conclude that the RVRS demands a very restrictive referral pattern if it should be of prognostic value for the blood pressure outcome after intervention. No indices of lateralised renin concentrations proved high predictive value. However, a peripheral renin concentration low in the normal range seems useful as an indicator of no benefit from intervention.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. McNair A et al. A follow-up study of hypertensivepatients after operative treatment of unilateral renovascular or renal disease Acta Med Scand 1979 205: 569–574

    Article  CAS  Google Scholar 

  2. Blaufox MD, Middleton ML, Bongiovanni J, Davis BR . Cost efficacy of the diagnosis and therapy of renovascular hypertension J Nucl Med 1996 37: 171–177

    CAS  PubMed  Google Scholar 

  3. Derkx FH et al. Renal artery stenosis towards the year 2000 J Hypertens Suppl 1996 14: S167–S172

    CAS  PubMed  Google Scholar 

  4. Mann SJ, Pickering TG . Detection of renovascular hypertension State of the art: 1992 Ann Intern Med 1992 117: 845–853

    CAS  PubMed  Google Scholar 

  5. Bergrem H, Jervell J, Solheim DM, Flatmark A . Prognostic value of renal vein renin determination in suspected renovascular hypertension Acta Med Scand 1982 211: 387–391

    Article  CAS  Google Scholar 

  6. Jensen G et al. Treatment of renovascular hypertension: one year results of renal angioplasty Kidney Int 1995 48: 1936–1945

    Article  CAS  Google Scholar 

  7. Kuhlmann U et al. Long-term experience in percutaneous transluminal dilatation of renal artery stenosis Am J Med 1985 79: 692–698

    Article  CAS  Google Scholar 

  8. Roubidoux MA et al. Renal vein renins: inability to predict response to revascularization inpatients with hypertension Radiology 1991 178: 819–822

    Article  CAS  Google Scholar 

  9. Sellars L, Shore AC, Wilkinson R . Renal vein renin studies in renovascular hypertension – do they really help? J Hypertens 1985 3: 177–181

    Article  CAS  Google Scholar 

  10. Svetkey LP et al. Prospective analysis of strategies for diagnosing renovascular hypertension Hypertension 1989 14: 247–257

    Article  CAS  Google Scholar 

  11. van Jaarsveld BC et al. The effect of balloon angioplasty on hypertension in atherosclerotic renal-artery stenosis. Dutch Renal Artery Stenosis Intervention Cooperative Study Group N Engl J Med 2000 342: 1007–1014

    Article  CAS  Google Scholar 

  12. Rasmussen S . Unpublished data from the Glostrup Population Survey: MONI 10 study. Unpublished data from the Glostrup Population Survey: MONI 10 study 1998

  13. Taylor A et al. Consensus report on ACE inhibitor renography for detecting renovascular hypertension. Radionuclides in Nephrourology Group. Consensus Group on ACEI Renography J Nucl Med 1996 37: 1876–1882

    CAS  PubMed  Google Scholar 

  14. Poulsen K, Jorgensen J . An easy radioimmunological microassay of renin activity, concentration and substrate in human and animal plasma and tissues based on angiotensin I trapping by antibody J Clin Endocrinol Metab 1974 39: 816–825

    Article  CAS  Google Scholar 

  15. Millar JA et al. A microassay for active and total renin concentration in human plasma based on antibody trapping Clin Chim Acta 1980 101: 5–15

    Article  CAS  Google Scholar 

  16. Sato K et al. Renal vein plasma renin activity inpatients, with unilateral renovascular hypertension Jpn Circ J 1988 52: 431–436

    Article  CAS  Google Scholar 

  17. Vaughan ED et al. Renovascular hypertension: renin measurements to indicate hypersecretion and contralateral suppression, estimate renal plasma flow, and score for surgical curability Am J Med 1973 55: 402–414

    Article  Google Scholar 

  18. Pickering TG, Sos TA, Vaughan EDJ, Laragh JH . Differing patterns of renal vein renin secretion inpatients with renovascular hypertension, and their role in predicting the response to angioplasty Nephron 1986 44 (Suppl 1): 8–11

    Article  Google Scholar 

  19. Radermacher J, Brunkhorst R . Diagnosis and treatment of renovascular stenosis – a cost-benefit analysis Nephrol Dial Transplant 1998 13: 2761–2767

    Article  CAS  Google Scholar 

  20. Morganti A . Renal angioplasty: better for treating hypertension or for rescuing renal function? J Hypertens 1999 17: 1659–1665

    Article  CAS  Google Scholar 

  21. Pedersen EB et al. Renovascular hypertension. Ability to renal vein ratio to predict the blood pressure level 18–24 months after surgery Nephron 1986 44 (Suppl 1): 29–31

    Article  Google Scholar 

  22. Radermacher J et al. Use of Doppler ultrasonography to predict the outcome of therapy for renal-arterystenosis N Engl J Med 2001 344: 410–417

    Article  CAS  Google Scholar 

  23. Isles C et al. Survival associated with renovascular disease in Glasgow and Newcastle: a collaborative study Scott Med J 1990 35: 70–73

    Article  CAS  Google Scholar 

Download references

Author information

Author notes

  1. P Hasbak, L T Jensen and H Ibsen: Members of the study group: H Dige-Petersen, A Leth, M Brahm, S Schifter, S Rasmussen, Glostrup Hospital; S Strandgaard, S Dorph, F Rasmussen, Herlev Hospital; JK Christoffersen, JO Lund, S Just, N Baekgaard, LP Jensen Gentofte Hospital; A Høegholm, Naestved Hospital; K Rasmussen, Roskilde Hospital.

Authors and Affiliations

  1. Department of Clinical Physiology and Nuclear Medicine, Glostrup Hospital, Denmark

    P Hasbak

  2. Department of Clinical Physiology and Nuclear Medicine, Gentofte Hospital, Denmark

    L T Jensen

  3. Department of Internal Medicine, Glostrup Hospital, Denmark

    H Ibsen

Authors
  1. P Hasbak
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. L T Jensen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. H Ibsen
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

The East Danish Study Group on Renovascular Hypertension

Corresponding author

Correspondence to P Hasbak.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hasbak, P., Jensen, L., Ibsen, H. et al. Hypertension and renovascular disease: follow-up on 100 renal vein renin samplings. J Hum Hypertens 16, 275–280 (2002). https://doi.org/10.1038/sj.jhh.1001365

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.jhh.1001365

Keywords

This article is cited by

Search

Advanced search

Quick links