Primary Reninism: Hypertension, Hyperreninaemia and Secondary Aldosteronism Due to Juxtaglomerular Renal Cell Tumours

1973 ◽  
Vol 45 (s1) ◽  
pp. 279s-282s
Author(s):  
J. W. Conn ◽  
E. L. Cohen ◽  
W. J. McDonald ◽  
W. M. Blough ◽  
C. P. Lucas ◽  
...  

1. A further case of renin-secreting renal juxtaglomerular cell tumour is reported. 2. Hypertension, aldosteronism and hypokalaemia were associated with high peripheral levels of renin. 3. Renin activity was twice as high in right as in left renal vein plasma. 4. A renal juxtaglomerular cell tumour was found in the right kidney and removed, after which the biochemical abnormalities and blood pressure were promptly corrected. 5. Explants of tumour tissue in culture produced large amounts of renin.

1981 ◽  
Vol 96 (2) ◽  
pp. 235-242 ◽  
Author(s):  
Lennart Hulthén ◽  
Kjell Jonsson ◽  
Harry Lecerof ◽  
Bernt Hökfelt

Abstract. Blood kinin concentration and plasma renin activity (PRA) were determined in the renal veins and in the inferior caval vein (ICV) below the level of the renal veins in 9 normal individuals (5 men and 4 women) and 7 patients with primary aldosteronism (3 men and 4 women). PRA in the renal veins and ICV was significantly lower and plasma aldosterone concentration in ICV significantly higher in the patients as compared to the normals. Kinin concentration in the renal veins and ICV did not differ significantly between the patients and the normals (0.31 ± 0.04 (mean ± sem) vs 0.45 ± 0.03 and 0.27 ± 0.05 vs 0.45 ± 0.06 μg/l, respectively). In the normal individuals kinin concentration and PRA were inversely related in the left renal vein (r = −0.80; P < 0.02), whereas this relation did not reach statistical significance in the right renal vein (r = −0.60; P < 0.10). Kinin concentration in both renal veins was positively correlated to kinin concentration in ICV (r = 0.73; P < 0.05 and r = 0.83; P < 0.02 for the right and left renal vein, respectively). These results indicate that intrarenal kinin formation and renin release are inversely related in normal subjects. Furthermore, they suggest that one and the same enzyme, possibly renal kallikrein, may be implicated in the kinin formation in the systemic as well as in the renal circulation. Intrarenal kinin formation seems not to be increased in primary aldosteronism.


2017 ◽  
Vol 16 (2) ◽  
pp. 174-177 ◽  
Author(s):  
Satheesha Badagabettu Nayak ◽  
Ashwini Aithal Padur ◽  
Naveen Kumar ◽  
Deepthinath Reghunathan

Abstract Variations of the testicular veins are relevant in clinical cases of varicocele and in other therapeutic and diagnostic procedures. We report herein on a unique variation of the left testicular vein observed in an adult male cadaver. The left testicular vein bifurcated to give rise to left and right branches which terminated by joining the left renal vein. There was also an oblique communication between the two branches of the left testicular vein. A slender communicating vein arose from the left branch of the left testicular vein and ascended upwards in front of the left renal vein and terminated into the left suprarenal vein. The right branch of the testicular vein received an unnamed adipose tributary from the side of the abdominal aorta. Awareness of these venous anomalies can help surgeons accurately ligate abnormal venous communications and avoid iatrogenic injuries and it is important for proper surgical management.


1992 ◽  
Vol 262 (3) ◽  
pp. R524-R529 ◽  
Author(s):  
N. D. Binder ◽  
D. F. Anderson

We examined the relationship between acute reductions in renal perfusion pressure, as approximated by femoral arterial blood pressure, and plasma renin activity in the uninephrectomized fetal lamb. Renal perfusion pressure was reduced and maintained at a constant value by controlled partial occlusion of the aorta above the renal artery. After 15 min of reduced blood pressure, blood samples were taken for determination of plasma renin activity. This protocol was performed 22 times in 11 fetal lambs. Additionally, three of the fetuses were delivered by cesarean section and studied as newborns for the first week of life. In the fetus, there was a linear relationship between log plasma renin activity and femoral arterial blood pressure (P less than 0.01). After birth, the relationship still existed, although it was shifted to the right (P less than 0.0001). We conclude that there is a significant relationship between plasma renin activity and renal perfusion pressure in the fetal lamb, and as early as 1 day after birth, this relationship shifts to the right in the newborn lamb.


1959 ◽  
Vol 197 (5) ◽  
pp. 1093-1096
Author(s):  
Joseph H. Perlmutt

The effect of increased pressure in one kidney, produced by ligation of its vein, on contralateral renal function was investigated in eight anesthetized dogs. Kidney function was determined under the same experimental conditions in five dogs, but without renal vein ligation. For the latter group, renal function, on the average, remained reasonably stable. After left renal vein ligation, findings for the right kidney were as follows: a) decreased urine flow, amounting maximally to 9.5–41.4% of control flows; b) slight increase of questionable significance in creatinine clearance; c) inconstant changes in PAH clearance; d) increase in urine osmolality to hypertonic values; e) decrease in solute-free water clearance; f) slight rise of questionable significance in total solute clearance; and g) either no change or inconstant changes in excretion rates Na+ and K+. The data indicate that the oliguria resulted solely from increased renal tubular reabsorption of water, suggesting liberation of antidiuretic hormone as the possible mechanism. Direct nervous influences on tubular reabsorption of water cannot, however, be presently ruled out.


1997 ◽  
Vol 115 (3) ◽  
pp. 1456-1459 ◽  
Author(s):  
José Carlos Costa Baptista-Silva ◽  
Marcos José Veríssimo ◽  
Marcos Joaquim Castro ◽  
André Luiz Guimarães Câmara ◽  
José Osmar Medina Pestana

The anatomical variations of renal veins observed during 342 nephrectomies in living donors are described, 311 cases on the left side and 31 on the right. The following anatomy of the renocava veins was observed: 1. On the left side the renal vein was always unique (311/311) and had two tributaries (suprarenal and gonadal veins) in 100 per cent and one or more renolumbar veins in 65.27 per cent, encircling the aorta in 1.07 per cent, was retroaortic in 1.4 per cent; and the inferior vena cava was double in 0.64 per cent; B- on the right side the renal vein was double in 29 per cent (9/31) and had only one tributary (gonadal vein) in one case, for 3.22 per cent (1/ 31); three or more renal veins in 9.7 per cent (3/31). We concluded that the left renal vein is always unique, presenting variations principally in its tributaries and trajectory. On the right side, the renal vein was double or triple in 38.79 per cent


2011 ◽  
Vol 11 ◽  
pp. 1031-1035 ◽  
Author(s):  
Obi Ekwenna ◽  
Michael A. Gorin ◽  
Miguel Castellan ◽  
Victor Casillas ◽  
Gaetano Ciancio

Nutcracker syndrome is described as the symptomatic compression of left renal vein between the aorta and the superior mesenteric artery, resulting in outflow congestion of the left kidney. We present the case of a 51-year-old male with a left-sided inferior vena cava, resulting in compression of the right renal vein by the superior mesenteric artery. Secondary to this anatomic anomaly, the patient experienced a many-year history of flank pain and intermittent gross hematuria. We have termed this unusual anatomic finding and its associated symptoms as the “inverted nutcracker syndrome”, and describe its successful management with nephrectomy and autotransplantation.


2018 ◽  
Vol 7 (03) ◽  
pp. 139-140
Author(s):  
Anly Antony ◽  
J. Sujitha Jacinth

Abstract Background: Infertility is considered a major public health issue. A multicentric WHO study showed increased frequency of varicocele in infertile couples to vary geographically from 6% to 47%. Some theorize, varicocele results due to anatomical differences between the right and left testicular veins. This disparity is believed, leads to increase in hydrostatic pressure of the left testicular vein, which is subsequently transferred to the venous plexus, causing dilation. Hence knowledge of testicular venous pattern and its variations takes paramount importance. Aims: To study anatomy of testicular veins with focus on: a] normal and occurrence of varying number and patterns of testicular veins b] to find explanations for incidence of some anomalies c] to consider surgical significance of such variations and d] to compare the results of the present study with previous studies. Materials and methods: The study material comprised of 25 embalmed, adult human male cadavers of south Indian origin. Systematic dissection was carried out following the guidelines of Cunninghairr s Manual of Practical Anatomy. Results: On five sides, four testicular veins were found at the deep inguinal ring. On the left side, all testicular veins terminated in the left renal vein with some showing duplication. Variations in the terminations of testicular veins were seen in three of the right sides, which included termination in the right renal vein, junction of the inferior vena cava with the right renal vein and in one case following duplication, veins terminated on the anterior and lateral wall of the inferior vena cava. Conclusion: Termination of testicular veins followed standard text book pattern on the left side, however a slight increase in the duplication of veins was observed on this side. On the right side, testicular veins showed variations in the site of termination and also duplication. Knowledge of these findings can be of importance in clinical practice related to the problems of the testis.


2019 ◽  
Vol 53 (7) ◽  
pp. 585-588
Author(s):  
Ewa J. Bialek ◽  
Bogdan Malkowski

We report a unique case of unusual drainage of the bifurcated retroaortic left renal vein, with the cranial wider branch draining into a dilated lumbar azygos vein and caudal thinner branch connecting with the inferior vena cava. The right renal vein was duplicated. The anomaly was discovered on multimodal 18F-labeled fluorodeoxyglucose positron emission tomography/computed tomography performed for oncological purposes. The basis enabling occurrence of such variation was probably persistent developmental extra left–right venous connections, intercardinal, or intersupracardinal, depending on the theory. The embryology of the chest and abdominal veins is a complicated process and there is no unanimity concerning its concepts. The old models are currently being questioned and reevaluated. Knowledge of possible variants of renal and azygos veins course is important from clinical, imaging, and surgical points of view. The retroaortic left renal veins course may sometimes cause pain, hematuria, proteinuria, and pelvic congestion syndromes. Dilated parts of uncommonly located veins, because of assuming a nodular shape on transverse images, may be mistaken for abnormal lymph nodes, other tumors or aneurysms on imaging. During a variety of surgical procedures, including venous sampling, renal transplantation, or any retroperitoneal surgery, knowledge of an aberrant venous course may be important for the success of the procedure and may be crucial even earlier during the qualification process.


2020 ◽  
Vol 8 (34) ◽  
pp. 52-55
Author(s):  
Ryan Dean ◽  
Ganesh Maniam ◽  
Thien Vo

While hematogenous spread of renal cell carcinoma (RCC) is common, isolated extension into the renal vein and inferior vena cava (IVC) is rare and extension to the right atrium is even less likely. In the case, a 62-year-old Hispanic female was admitted for a suspected inferior myocardial infarction, and her echocardiogram revealed a right atrial mass consistent with the appearance of an atrial myxoma. Following cardiac catheterization, a histopathological examination of the mass revealed a clear cell tumor consistent with metastatic clear cell RCC. Following a CABG with excision of the atrial mas, the CT demonstrated a 5 cm right lower pole renal mass with hilar involvement, as well as filling defects in the IVC extending into the right renal vein; these findings were consistent with RCC tumor thrombus extension into the renal vein, IVC, and right atrium. The radical nephrectomy necessary for tumor removal could not be performed at this hospital, so the patient was discharged to a higher level of care. The incidence rate for RCC with extension into the right atrium is quite low, but clinicians should understand the lethality of RCC warrants immediate clinical investigation upon diagnosis. The increased utilization of sophisticated imaging modalities will likely continue to increase the rate of incidental discovery of such neoplasms, and physicians should keep RCC on the differential when a right atrial mass is discovered incidentally on echocardiogram.


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