“No man's land” of the renal vasculature

An arteriographic and hemodynamic assessment of the interlobar and arcuate arteries in essential and accelerated hypertension
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      A highly significant correlation has been demonstrated between abnormalities at the interlobar and arcuate artery level in selective renal arteriograms of sixty-six patients with essential hypertension and several clinical indices including the age of the patient and the duration, severity and presence of complications of hypertension. The vascular abnormality at this level also shows a significant correlation with intrarenal hemodynamics assessed by 133Xe washout and renal function. The hemodynamic and arteriographic changes suggest the presence of focal cortical areas of decreased perfusion in many patients, which may well contribute to the progress and severity of the hypertension.
      The arterial changes at this level have also been shown to progress with age in a normal population. This age-related change is potentiated in hypertensive subjects.
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        • McCormack J.
        • Beland E.
        • Schneckloth E.
        • Corcoran A.C.
        Effects of antihypertensive treatment on the evolution of the renal lesions in malignant nephrosclerosis.
        Am. J. Path. 1958; 34: 1011
        • Bell E.T.
        Renal Diseases.
        in: Lea & Febiger, Philadelphia1950: 341
        • Hollenberg N.K.
        • Rosen S.M.
        • O'Connor J.F.
        • Potchen E.J.
        • Basch R.
        • Dealy Jr., J.B.
        • Merrill J.P.
        Effect of aortography on renal hemodynamics in normal man.
        Invest. Radiol. 1968; 3: 92
        • Hollenberg N.K.
        • Epstein M.
        • Basch R.I.
        • Couch N.R.
        • Merrill J.P.
        • Hickler R.B.
        Renin secretion in essential and accelerated hypertension.
        Am. J. Med. 1969; 47: 855
        • Thorburn G.D.
        • Kopald H.H.
        • Herd J.A.
        • Hollenberg M.
        • Morchoe C.C.C.
        • Barger A.C.
        Intrarenal distribution of nutrient blood flow determined with Krypton-85 in the unanesthetized dog.
        Circulation Res. 1963; 13: 290
        • Rosen S.M.
        • Hollenberg N.K.
        • Dealy J.B.
        • Merrill J.P.
        Measurement of the distribution of blood flow in the human kidney using the intra-arterial injection of 133Xe. Relationship to function in the normal and transplanted kidney.
        Clin. Sc. 1968; 34: 287
        • Ingvar D.H.
        • Lassen N.A.
        Regional blood flow of the cerebral cortex determined by Krypton-85.
        Acta physiol. scandinav. 1962; 54: 325
        • Ladefoged J.
        Measurements of the renal blood flow in man with the 133Xe washout technique.
        Scandinav. J. Clin. & Lab. Invest. 1966; 18: 299
        • Kioschos J.M.
        • Kirkendall W.M.
        • Valenca M.R.
        • Fitz A.E.
        Unilateral renal hemodynamics and characteristics of dye-dilution curves in patients with essential hypertension and renal disease.
        Circulation. 1967; 35: 229
        • Kincaid-Smith P.
        • McMichael J.
        • Murphy E.A.
        The clinical course and pathology of hypertension with papilledema (malignant hypertension).
        Quart. J. Med. 1958; 27: 117
        • Chasis H.
        Renal hemodynamics in essential hypertension.
        in: Bell E.T. Hypertension. A Symposium. University of Minnesota, Minneapolis1951: 227
        • Friedman M.
        • Selzer A.
        • Rosenblum H.
        The renal blood flow in hypertension as determined in patients with variable, with early and with long-standing hypertension.
        J.A.M.A. 1941; 117: 92
        • Barajas L.
        • Lupu A.N.
        • Kaufman J.J.
        • Latta H.
        • Maxwell M.H.
        The value of the renal biopsy in unilateral renovascular hypertension.
        Nephron. 1967; 4: 231
        • Sommers S.C.
        • Relman A.S.
        • Smithwick R.H.
        Histologic studies of kidney biopsy specimens from patients with hypertension.
        Am. J. Path. 1958; 34: 685
        • Hulet W.H.
        • Baldwin D.S.
        • Biggs A.W.
        • Gombos E.A.
        • Chasis H.
        Renal function in the separate kidneys of man. I. Hemodynamics and excretion of solute and water in normal subjects.
        J. Clin. Invest. 1960; 39: 389
        • Smith H.W.
        • Goldring W.
        • Chasis H.
        • Ranges H.A.
        • Bradley S.E.
        Application of saturation methods to the study of glomerular and tubular function in the human kidney.
        J. Mt. Sinai Hosp. 1943; 10: 59
        • Lowenstein J.
        • Steinmetz P.R.
        • Effros R.M.
        • Demeester M.
        • Chasis H.
        • Baldwin D.S.
        • Gomez D.M.
        The distribution of intrarenal blood flow in normal and hypertensive man.
        Circulation. 1967; 35: 250
        • Cohn J.N.
        • Gombos E.A.
        Unilateral renal hemodynamics studied by an indicator-dilution technic in man.
        Am. J. Cardiol. 1965; 16: 820
        • Thurau K.
        Renal hemodynamics.
        Am. J. Med. 1964; 36: 698
        • Hollenberg N.K.
        • Epstein M.
        • Rosen S.M.
        • Dammin G.J.
        • Merrill J.P.
        Vascular lesions of the transplanted human kidney: morphologic and hemodynamic studies in chronic rejection.
        Tr. Am. A. Physicians. 1968; 81: 274
        • Castleman B.
        • Smithwick R.H.
        The relation of vascular disease to the hypertensive state. II. The adequacy of the renal biopsy as determined from a study of 500 patients.
        New England J. Med. 1948; 239: 729
        • Tellem M.
        Progression of target organ damage from sustained diastolic hypertension.
        Am. J. Cardiol. 1966; 17: 604
        • Ljungqvist A.
        The intrarenal arterial pattern in essential hypertension; a micro-angiographic and histologic study.
        J. Path. & Bact. 1962; 84: 313
        • Libretti A.
        • Grazi S.
        Diagnostic value of selective renal arteriography in hypertension.
        in: Gross F. Antihypertensive Therapy, Principles and Practice. An International Symposium (CIBA). Springer-Verlag, Berlin1966: 503