RENAL VENOUS PRESSURE IN CHRONIC CONGESTIVE HEART FAILURE 1

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Abstract
Pressures are recorded directly on a saline manometer from the renal vein, inferior vena cava, right atrium and arm vein in a group of control subjects and in patients with right-sided heart failure. A zero point of 10 cm. above the table top, as checked by lateral X-rays, was used for renal venous and vena caval measurements; 6.6 cm. below the angle of Louis was used for atrial and peripheral points of reference and for comparative measurements within the same individual. Renal venous pressure averaged 152 mm. saline in the control group and 270 in the cardiac subjects. Pressures from all sources were higher in the cardiac group, with smaller differences between the atrium and all other sites. By the use of equations it is shown that afferent, efferent and total renal resistance are substantially increased over the normal values in subjects in congestive heart failure, demonstrating constriction of both afferent and efferent arterioles. Renal vasomotor changes are responsible in great part for decreased renal plasma flow and filtration rate.