Article

Observations Concerning Renal Circulation

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Abstract

SINCE aberrations in the renal circulation in experimental animals can be demonstrated by angiography,1–5 the present study was undertaken for two purposes: (1) to determine whether there are roentgenographically detectable alterations in the arterial system of kidneys removed from hypertensive patients; and (2) if such alterations are present, to determine whether they can be recognized by clinical renal angiography.

Material and Methods

Twenty-nine excised kidneys were selected from necropsy or from surgical specimens. Sixteen of the kidneys were from hypertensive and 13 from normo-tensive patients.

Angiography of excised kidneys. A barium-latex suspension having a particle size of approximately 30 microns was injected through a cannula into the main renal artery of each kidney. This particle size prevented the passage of the material through the capillaries into the venous system. To obtain good renal filling, the suspension was injected by manometric control under a pressure greater than the patient's usual diastolic pressure by from 10 to 20 mm. Hg. In a few instances higher pressures were used, but there was no apparent increase in the vascular filling. The cannula was removed and the vessels were ligated. Roentgenograms of the kidney were then made using a cardboard technic with a 40-inch focal-film distance. The technical factors were 50 milliamperes, 35 kilovolts, and 1½ seconds.

Findings

The pathologic diagnoses of the conditions of the 29 kidneys are listed in Table 1.

Arterial system in normal kidneys from normotensive patients. The roentgenograms of the three normal kidneys (Group 1, Table 1) were notable. . .


 

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