Q:

Samples taken from the ureters of a man with severe one-sided renal artery stenosis gave the results shown in the table below. Plasma creatinine level was 1 mg/100 ml and the PAH level was 3 mg/100 ml. In this patient:

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Samples taken from the ureters of a man with severe one-sided renal artery stenosis gave the results shown in the table below. Plasma creatinine level was 1 mg/100 ml and the PAH level was 3 mg/100 ml. In this patient:

  Left ureter Right ureter
Urine volume (ml/minute) 0.2 6.0
Creatinine conc (mg/100 ml)  100.0 10.0
PAH conc (mg/100 ml) 1000.0 150.0

  1. Glomerular filtration rate (creatinine clearance) was 10 times as great on the left side as on the right.
  2. Renal plasma flow was approximately 67 ml/minute on the left.
  3. Renal blood flow was 900 ml/minute on the right (haematocrit=33 per cent).
  4. The right kidney had the narrowed renal artery.
  5. It is likely that he was hypertensive.

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 a. False Creatinine clearance (UV/P) was 20 ml/minute on the left and 60 ml/minute (normal) on the right.

b. True From PAH clearance – a very low value.

c. False Blood flow=plasma flow x 1/1- Ht= 300 x 3/2=450 ml/minute.

d. False The left side had the abnormality.

e. True Due to excessive renin release from the ischaemic kidney; the excessive renin leads to excessive formation of angiotensin I and angiotensin II; the latter constricts blood vessels and increases plasma volume.

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