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Report of a Patient With Unilateral Disease, Elevated Renin Activity Levels, and Reversal After Unilateral Nephrectomy

Alvin P. Shapiro, MD; Tito Cavallo, MD; William Cooper, MD; Don Lapenas, MD; Klaus Bron, MD; George Berg, MD

Arch Intern Med. 1977;137(7):848-851.

Abstract
A patient received intensive radiation to the right renal area for abdominal Hodgkin's disease and approximately ten years later severe hypertension developed. The presence of radiation nephritis with a severely shrunken right kidney was demonstrated and this was accompanied by a substantial increase in renin activity from the right kidney. Treatment with propranolol hydrochloride temporarily lowered the blood pressure and peripheral renin activity levels. Subsequent right nephrectomy resulted in a decrease in renin activity and a reversal of the hypertension. The data implicate a renin angiotensin mechanism as a probable cause of hypertension in radiation nephritis.

(Arch Intern Med 137:848-851, 1977)

Author Affiliations
From the Departments of Medicine (Drs Shapiro and Cooper), Surgery (Dr Berg), and Radiology (Dr Bron), Presbyterian-University (Pittsburgh) Hospital, the Department of Pathology (Drs Cavallo and Lapenas), Montefiore (Pittsburgh) Hospital, and the University of Pittsburgh School of Medicine.

Footnotes
Accepted for publication Aug 6, 1976.

Reprint requests to Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261 (Dr Shapiro).

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