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Renovascular and Renal Parenchymatous Hypertension (Paperback, Softcover reprint of the original 1st ed. 1992)
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Discovery Miles 29 580
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Renovascular and Renal Parenchymatous Hypertension (Paperback, Softcover reprint of the original 1st ed. 1992)
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Ever since Richard Bright discovered the link between kidney
disease and cardiac hypertrophy inhispioneeringworkin 1827,
thefieldofrenovascularandrenal parenchy matous hypertension has
been a transatlantic adventure. Towards the end of the nine teenth
century, Tigerstedt and Bergman discovered that the kidneys contain
a factor whichraisedbloodpressurewheninjected intointactanimals.
Theynamedthesubstance renin, which is now known as the crucial
enzyme activating the angiotensin aldosterone system, which is so
pertinent in the regulation of blood pressure and kidney function.
After this crucial European contribution to the field, Harry
Goldblatt at the Cleveland Clinic demonstrated in his classical
experiments that reduction in renal blood flow, by placing a clamp
at the major renal artery, could induce sustained hypertension.
These discoveries established the role of the kidney in certain
forms of hypertension which are now classified as renovascular and
renal parenchymatous hypertension. These fundamental concepts
suggested - based on experimental evidence - that restoration of
blood flow or nephrectomy in unilateral parenchymatous disease
would lead to blood pressure normalization in these patients.
Indeed, as early as the first half of this century, a report
appeared demonstrating blood pressure normalization in a child with
fibromusculardisplasiaofthe right renalartery after nephrectomy.
Advances in surgical techniques later allowed reconstructive
renovascular surgery and therefore a more appropriate form of
therapy of the disease. In the late seventies Andreas Grtinzig
initiated another European contribution to renovascular
hypertension by introducting the procedure of percuteaneous
transluminal angioplasty, an elegant catheter technique allowing
non-surgical therapy of renovascular disease."
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