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April 1970

The Kidney in Endocrine Hypertension: Cushing's Syndrome, Pheochromocytoma, and Aldosteronism

Author Affiliations

St. Louis
From the departments of surgery (Dr. O'Neal), pathology (Drs. Kissane and Hartroft), and pediatrics (Dr. Kissane), Washington University, St. Louis.

Arch Surg. 1970;100(4):498-505. doi:10.1001/archsurg.1970.01340220174029

The hypertension associated with Cushing's syndrome, pheochromocytoma, and primary aldosteronism is generally alleviated by operations which relieve the endocrinopathy, and in most of these cases the blood pressure returns to normal levels. In a few cases, hypertension persists or recurs. This residual hypertension is seldom as severe as when the endocrinopathy was present, but confusion about its cause may arise. Open wedge biopsies of the kidney done at the time of adrenal operations have been useful in evaluating the cause and in predicting the course of the residual hypertension.

Methods and Materials  The patients seen at Barnes Hospital and Washington University, St. Louis, during the last 20 years have been reviewed. The preoperative blood pressures are the initial resting valves after hospital admission, and the postoperative and follow-up blood pressures are averages of several resting measurements.Open wedge biopsy of the kidney has been done in several cases. Most often