Abstract
The renal mechanisms involved in sustaining hypertension were evaluated in 7 children ages 5-11 with coarctation. IRBFD was determined following renal artery injections of 133Xe which measures rates of flow and the fraction of total renal blood flow to the outer cortical (OC) nephrons in which renin is produced. RRSR was calculated by multiplying OC flow by the renal venous minus arterial difference in immunoreactive plasma renin activity (PRA). When measurements were made in both kidneys (4 children), results between the kidneys were averaged. when compared to data obtained in 8 normal kidneys the following was found in the 7 children with coarctation and 5 patients with L-R shunts. OC flow was reduced in children with shunts or coarctation (p < 0.01). Fractional flow to the OC was reduced only in children with shunt lesions (p <0.01). RRSR in shunt lesions (430±201 SEM) were not different from that observed in coarctation (201 ng/ml/min/100 gm ± 92 SEM) (p = 0.28). These findings as well as the demonstration of normal renin profiling in three children (4 hr upright PRA vs. 24 hr. urinary sodium excretion compared to a series of approximately 100 normal children) with coarctation suggest that the persistence of hypertension in coarctation is independent of the renin angiotensin system and compatible with the experimental two kidney model of hypertension.
Supported in part by NIH grant HE12651, RR-75 and RR-5624).
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Gruskin, A., Auerbach, V., Black, I. et al. 116 INTRARENAL BLOOD FLOW DISTRIBUTION (IRBFD) AND RENAL RENIN SECRETORY RATES (RRSR) IN CHILDREN WITH COARCTATION. Pediatr Res 12 (Suppl 4), 383 (1978). https://doi.org/10.1203/00006450-197804001-00121
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DOI: https://doi.org/10.1203/00006450-197804001-00121