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  #1  
Old 07-22-2011
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Kidney Renin concentration in Renal Artery Stenosis!

A 65-year-old man with severe headaches is examined by his physician. His blood pressure is 170/115 mm Hg, and a bruit is heard over the right flank. Further testing reveals stenosis of the right renal artery. What pattern of renin concentrations in the right and left renal veins is expected?

A. Right – increased; left – decreased
B. Right – increased; left – increased
C. Right – increased; left – normal
D. Right – decreased; left – decreased.
E. Right – decreased; left – increased
F. Right – decreased; left – normal
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  #2  
Old 07-22-2011
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Default B or C

Hm, thats a good question!

I've narrowed it down to between B or C.

But I would go with B. Right-increased; Left-increased.
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Old 07-22-2011
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I am with A, Right increased and left decreased.
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  #4  
Old 07-22-2011
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i'll go with A...

based on that the "unaffected site is receiving a high blood content... because the other say is making the system to work harder to get more blood... to increase pressure.

in Renal Artery Stenosis, The affected site increase more than 50% of the renin levels..
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Old 07-22-2011
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A. rt increased, lt decrease.
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Old 07-23-2011
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the answer is C
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  #7  
Old 07-23-2011
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Star B

B. Right – increased; left – increased

because the renin from right side initially will cause vasoconstriction which is generalized. This will lead to fall in GFR bilaterally eventually leading to Increased renin output from both the kidneys!
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Old 07-23-2011
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I think its A
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Old 07-23-2011
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gotta be A
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Old 07-23-2011
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A. right - increased renin; left - decreased renin
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Old 07-23-2011
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I think it's A cuz the blood pressure must have been normal at first but the right kidney due to renal artery stenosis wud have detected a decrease in blood flow and therefore it wud increase renin secretion from JG, that wud have caused an abnormal rise in blood pressure and the left normal kidney wud have suppressed renin secretion cuz it detected that increase in blood pressure...
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Old 07-23-2011
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A. Right – increased; left – decreased

increase in renin will lead to AT2 rise which will constrict the efferent arterioles in both kidneys. This will lead to improvement in the GFR in the right kidney but increase in GFR in the left. So to return the GFR on the left kidney to normal level the left would decrease the renin release.
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Last edited by axax; 07-23-2011 at 06:47 AM.
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Old 07-23-2011
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i say A too
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  #14  
Old 07-23-2011
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Tricky yet simple, I hope I got this, its A. Block the rt side increases blood to left kidney so less renin (same as 2 posts up).
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Old 07-23-2011
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i think RT increased and left decreased
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Old 07-23-2011
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my answer B. Right – increased; left – increased
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Old 07-23-2011
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Correct Answer Correct answer

The correct answer is A. Right – increased; left – decreased

The bruit over the right flank is consistent with right renal artery stenosis, which causes decreased right renal perfusion pressure, increased renin secretion from the right kidney, and increased renin levels in the right renal vein. The increased renin secreted by the right kidney is added to the general circulation and leads to increased production of angiotensin II, increased secretion of aldosterone, and ultimately increased arterial pressure. The increased arterial pressure is “seen” by the normal left kidney, which responds appropriately by decreasing its renin secretion.
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  #18  
Old 07-25-2011
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I go for A, right increase,left decrease
reason been that the rightkidney with stenosed artery senses hypotension,therefore stimulate renin secretion.>angiotensin 2>water retension,increase cardiac activity etc>result in the features of hypertension see in the patient.
The left normal side on the other hand senses this hypertensive state,so it reduces the production of renin
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