[Behavior of plasma-renin-activity during hemodialysis and orthostasis in chronic nephropathies]

[Obliterative intimofibrosis of the renal arteries under the influence of hemodialysis in patients with chronic renal insufficiency (author's transl)]

Histologic and morphologic methods were employed to study the influence of chronic hemodialysis on kidney vessels in chronic renal insufficiency. Arteries of contracted kidneys from patients with and without hemodialysis treatment were investigated. The dialysis group was made up of 33 patients, 28 having undergone bilateral nephrectomy and 5 having died. The control group consisted of 21 patients with chronic renal insufficiency, who died in uremic coma without prior hemodialysis. A statistical evaluation was done by comparing measurements from corresponding arteries in the dialysis- and control groups. The correlation pattern from a BMD 03D-program, in which each group was separately assessed for the possible influence of various clinical findings, was determined. Clinical influences taken into account included the course of the kidney disease, grade of renal insufficiency, duration and degree of hypertension as affecting the renal arteries. The statistical results showed that hemodialysis treatment, even taking clinical data into consideration, influenced the development of intimal fibrosis in the arteries of contracted kidneys in an increasing positive manner. Decreased perfusion of the kidneys during hemodialysis suggested as a possible cause. The examination of early lesions in renal arteries following short-term dialysis treatment lends support to this possibility. Here edema and proliferation of the intimal cells in the arteries, similar to that in vessels having a reduced blood flow, is observed.