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September 1962

Sympathectomy for Glomerulonephritis with Hypertension

Author Affiliations

From the Department of Surgery, Massachusetts Memorial Hospitals, Boston, and the Department of Pathology, Scripps Memorial Hospital, La Jolla, Calif.

Arch Surg. 1962;85(3):390-393. doi:10.1001/archsurg.1962.01310030038006

Clinically an established glomerulonephritis with hypertension may be difficult to distinguish from other forms of renal disease.1,2 In 9 of 1,380 patients who underwent bilateral lumbodorsal sympathectomy and renal biopsy in the treatment of hypertension during the years 1942 through 1958, a primary glomerulonephritis was not discovered preoperatively despite various chemical parameters of renal function, pyelography, and a careful history and physical examination. Repeated urinalyses failed to provide evidence indicative of glomerulonephritis, such as an increased excretion of protein, red cells, white cells, and granular casts. No patient had the nephrotic syndrome. In 3 of the cases, the clinical picture was that of a malignant, or nearly malignant, hypertension. This has been described as one of the masks of chronic glomerulonephritis.3 Histologically none were typical chronic proliferative glomerulonephritis, but instead were mild proliferative, membranous, inactive, or healed types.

The effect of sympathectomy upon this type of renal hypertension