Prognostic Value of Plasma Renin Activity in Renovascular Hypertension

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Abstract
Renin activity was measured in 248 plasma samples from 78 hypertensive patients with unilateral angiographic renovascular lesions. The humeral (brachial), the two renal, and the suprarenal or the infrarenal caval, or both, veins were sampled. Peripheral vein renin was poorly correlated with surgical success. Venous renin from the involved kidney was better but still failed consistently to predict postoperative benefit. Only in blood from the suprarenal portion of the vena cava were renin levels of considerable prognostic value (87% accuracy) in operated patients. Increases at this level seem to reflect more closely absolute increments in renin secretion rates, whereas increases limited to the venous blood from a stenosed kidney seem to stem mostly from reduced renal blood flow. It is concluded that determination of suprarenal renin deserves a larger scale investigation to define its place among the preoperative tests used for predicting renosurgical benefit in unilateral renovascular hypertension.