At the present time the bulk of evidence seems to implicate pyelonephritis and various vascular lesions as the two main causes of renal hypertension. The theory is that an ischemic kidney elaborates a proteolytic enzyme (renin) which combines with a plasma globulin to produce an active pressor polypeptide which elevates the blood pressure. The manifestations of unilateral disease vary, but suspicion should be aroused when the history includes recent trauma to the abdomen or flank, abdominal or flank pain mimicking abdominal disease, a known source of emboli, and past pyelonephritis. Ureteral catheterization for measurement of sodium and water excretion will aid in the detection of an increased number of such
Dunn J, Brown H. UNILATERAL RENAL DISEASE AND HYPERTENSION: REPORT OF THREE SUCCESSFULLY TREATED CASES. JAMA. 1958;166(1):18–22. doi:10.1001/jama.1958.02990010020005
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