Diastolic hypertension is a frequent accompaniment of renal parenchymal and renovascular disease. Numerous developmental, inflammatory, neoplastic, and other acquired lesions may be responsible for diastolic blood pressure elevation. Although renal function may be measured by creatinine clearance, urine osmolarity, phenolsulfonphthalein excretion, and other studies, these various tests of renal functional capacity cannot identify the specific type of renal disorder or its causative relationship to diastolic hypertension. The most satisfactory diagnostic measures are pyelography, kidney biopsy, and renal arteriography. In addition, specific urinary findings may further identify particular lesions. The therapy of renal hypertension must be directed at the underlying pathology whenever possible. Where specific therapy is not available, adequate control of the blood pressure elevation may reduce or arrest the accompanying vascular deterioration.
Brest AN, Heider C, Moyer JH. Diagnosis of Renal HypertensionMedical Aspects. JAMA. 1961;178(7):718–722. doi:10.1001/jama.1961.03040460026006
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