A Synopsis of Renal Diseases by A. M. Davison (Auth.)

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By A. M. Davison (Auth.)

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T h e s t e n o t i c side s h o w s a delayed appearance of t h e d y e which b e c o m e s denser a n d persists longer t h a n in t h e n o r m a l k i d n e y . It is i m p o r t a n t t o ask for early films, in particular a n i m m e d i a t e o r 1 m i n u t e film. T h e s t e n o t i c k i d n e y m a y b e smaller t h a n t h e n o r m a l unaffected side. Notching of t h e renal pelvis a n d u r e t e r m a y be seen d u e t o t h e d e v e l o p m e n t of collateral b l o o d s u p p l y .

4. 5. 6. liver. However, if t h e p r o t e i n loss exceeds t h e ability of t h e liver t o increase p r o t e i n p r o d u c t i o n t h e r e will b e a r e d u c t i o n in t h e concen­ t r a t i o n of p r o t e i n in t h e plasma. T h e diminished plasma p r o t e i n c o n c e n t r a t i o n reduces t h e plasma o n c o t i c pressure and t h u s t h e r e will be an a c c u m u l a t i o n of fluid in t h e extravascular space. This fluid will originate from t h e plasma and so will result in h y p o v o l e m i a .

T h e e x a c t place of this test in t h e investigation of t h e h y p e r t e n s i v e p a t i e n t is n o t established and it is n o t invariably positive in cases of r e n i n - i n d u c e d h y p e r t e n s i o n . Clearly it requires detailed evaluation. RENAL ARTERY STENOSIS In renovascular disease a p p r o x i m a t e l y 7 0 per c e n t of p a t i e n t s have uni­ lateral a n d 30 per c e n t bilateral disease. Aetiology 1. F i b r o m u s c u l a r hyperplasia ( 3 0 per c e n t of cases).

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