泌尿器科領域における腎機能と血圧I泌尿器科疾患と血圧について 1.泌尿器科疾患と血圧について

Abstract

Clinical observations with main aspects on blood pres s ure and renal functions have been carried out on 543 patients with urinary tract infections (345 males and 198 females) who admitted to the Department of Urology at Hiroshima University Hospital during the period of 3 years and 8 months from January 1959 to August 1962. The results are summerized briefly as follows. 1) The highest r ate in association of hypertension was observed in patients with upper urinary tract diseases, especially in the bilaterally involved group. The rate was ranked at next places in the group of lower urinary tract diseases and then the group of unilateral upper urinary tract diseases. 2) Hypotension wa s observed in 23 cases, 4.2 % of the total, of which were symptomatic type in almost all instances. Relatively frequent association of hypotension was seen in patient with unilateral renal tuberculosis. 3) Frequency of hypertensi on was inclined to increase with extent of disturbances of total renal function. However, 46.4 % of hypertensive patients showed normal total renal function. 4) High frequency of hypertension was observed in association with bilateral renal tuberculosis, upper urinary tract lithiasis, cystic kidney, hydronephrosis and pyonephrosis. 5) In patients with unilateral hydronephrosis following gynecological ope ration, a relatively high frequent development of hypertension was observed. Nephrectomy of the involved side showed gave a good response to decrease the high blood pressure. 6) Histological examination of the removed kidney from patients with unilateral renal disease, in whom lowering of high blood pressure was achieved postoperatively, confirmed that the kidney had generalized parenchymal atrophic changes and arterio-and arteriolonephrosclerotic changes. 7) In view of urological therapeutic effects for hypertension, lowering of blood pressure can be expected in some degree by nephrectomy of the involved kidney and reconstruction of the urinary tracts. 8) A part of patients with hypertension of advanced age is thought to include ones due to prostatic hypertrophy.