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©2013 UpToDate ® Print Email Impaired aldosterone escape in renal artery stenosis The effect of the administration of aldosterone and a high Na+ diet on mean arterial pressure, cumulative Na+ balance, and urinary Na+ excretion in dogs. If renal perfusion pressure is held constant by use of a suprarenal aortic clamp, Na+ excretion remains at low levels and aldosterone escape does not occur. The net result is progressive Na+ retention and a marked elevation in systemic blood pressure. When, however, renal perfusion pressure is allowed to rise by release of the clamp, there is a spontaneous diuresis, leading to a return in Na+ balance toward normal and much less severe hypertension. (From Hall, JE, Granger, JP, Smith, MJ, Jr, Premen, AJ, Hypertension 1984; 6(2 Pt 2):I-183. By permission of the American Heart Association, Inc.)