Due to advanced diagnostic methodology more and more patients diagnosed with a so-called essential hypertension are detected with a dysfunction in the region of the adrenal cortex or the cortical collecting duct of the kidneys.
The management of the University Hospital of Berne Inselspital recognized these new achievements of medical research and supports an innovative service for an integrated diagnosis and therapy of arterial hypertension under the direction of the Department of Nephrology and Hypertension since June 2001.
The figure shows an GC/MS-analysis of the urine of a hypertensive patient with an overproduction of deoxycortico steron as a cause of the high blood pressure (from the laboratory of the Department of Nephrology and Hypertension).
MR investigation of the adrenal gland (performed at the Institute for Diagnostic Radiology of the University Hospital of Berne Inselspital). Such adenomas, which produce excessive amounts of hormones with mineralocorticoid effect and thereby induce arterial hypertension, are removed laparoscopically at the Urologic Clinic of the University Hospital of Berne Inselspital.
Analysis of the gene 11ß-hydroxysteroid dehydrogenase. The mutation of this gene leads to a missing inactivation of cortisol in the kidney of this female patient and thus to a cortisol induced sodium retention in the cortical collecting duct. This low renin, low aldosterone hypertension (laboratory of the Department of Nephrology and Hypertension) could be normalized by a rational pharmacotherapy.