急性腎盂腎炎と高レニン血症

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  • Thirty three patients with acute pyelonephritis were studied in regared to plasma renin activity and clinical courses
  • キュウセイ ジンウ ジンエン ト コウ レニン ケッショウ

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1. 63.6% of patients with active acute pyelonephritis had abnormally high plasma renin activity (PRA). They showed a decrease in urinary sodium excretion, a reduction in creatinine clearance, and high indices of inflammatory activity, 2. The changes of PRA in the cource of acute pyelonephritis were negatively crrelated to the urinary sodium excretion and creatinine clearance, but positively to the activity of inflammation, serum sodium concentration and the number of E. coli in urine. PRA values returned toward normal with the improvement of acute pyelonephritis and the restoration of sodium excretion and creatinine clearance, 3. Concerning to the mechanism of hyperreninemia in active stage of the diseases, we speculated the following three possibilities renal ischemia, reduced urinary sodium excretion and negative sodium balance of the body, and inflammation, We emphasized the second, that is, negative sodium balance of the body brought about by the severe inflammation in the kidneys which was the main cause of reduced urinary sodium excretion and renal ischemia. 4. The resting PRA in acute pyelonephritis might be to reflect the sodium status of the body, and have no relation to hypertension.

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