Effect of an oral Angiotensin I-Converting Enzyme Inhibitor on Blood Pressure and Renin-Angiotensin-Aldosterone System before and after Nephrectomy in two Cases with acute Renovascular Hypertension

Nephrectomy was performed for two cases with acute renovascular hypertension due to clamp injury (Case 1) and blunt lumbar trauma (Case 2), and it was followed by normal plasma renin activity (PRA) and normotension. Changes of blood pressure, pulserate, PRA, plasma aldosterone concentration (PAC) were observed by oral administration of Captopril (12.5mg) before and after nephrectomy. In pre-nephrectomy stage, blood pressure lowered remarkably, PRA increased, and PAC temporarily increased during observation in two cases, Pulse rate was ucchanged. In postnephrectomy stage, blood pressure lowered slightly, PRA increased, and PAC decreased in both cases. Pulse rate was unchanged. Accordingly, it is possible that temporary increase of PAC by oral administration of Captopril before nephrectomy depends on production of bradykinin and prostaglandins.