Hyperplasia of juxtaglomerular cells and renomedullary interstitial cells after renal arterial embolization in patients with renal cell carcinoma

Abstract

腎癌36例に腎摘除術ないしは腎動脈塞栓術兼腎摘除術を施行した.前者のみでは, 血圧は不変で, 測定したvasoactive substanceも変化しなかった.後者を施行すると, まず腎摘除術に先行して行った.腎動脈塞栓術により血圧は上昇し, 血漿レニン活性(PRA)と尿中プロスタグランディンE2 (PG)排泄量は正の相関をもって増加した.摘除腎には, 傍糸球体装置および髄質間質細胞の過形成が見られた.すなわち, 腎癌患者における急速な腎虚血はレニン分泌細胞の増殖とともにPG分泌細胞の増殖も惹起させることが推測された

Renal tissue was obtained from 36 patients with renal cell carcinoma, some of whom received renal arterial embolization. The removed specimens was examined histopathologically and the concentration of some vasoactive substances in these patients was measured. Nephrectomy alone produced no discernible changes in blood pressure, vasoactive substances determined or histopathological findings of the kidney. Renal arterial embolization raised the blood pressure in association with the elevation of plasma renin activity (PRA) and urinary prostaglandin (PG) E2 excretion. A linear relationship was found to exist between PRA and mean blood pressure (r = 0.70, p less than 0.001). Hyperplasia of the juxtaglomerular (JG) apparatus, and high granularity of sudan black B granules in renomedullary interstitial cells were confirmed in removed kidneys of patients who had received embolization alone. Subsequently high renin production would be anticipated to influence overproduction of renal PG E2 in acute ischemic kidney in patients with renal cell carcinoma, and hypertension following renal arterial embolization appears to be caused by the hyperplasia of the JG apparatus.