Renal Ischæmia and Hypertension : A Review of the Results of Surgery

Summary A review of the results of renal surgery in patients with hypertension reveals that 37% have a reduction in the blood pressure to 140/90 mm. Hg for a year. About half the patients achieve worthwhile clinical benefit from operation. The percentage of successful results in patients with renal artery disease or chronic pyelonephritis is almost double that achieved in other forms of unilateral renal disease. Patients aged under 20 years, and those with retinitis or papillœdema, seem to have a better prognosis for alleviation of hypertension than older patients or those with lesser retinal changes. When pyelonephritic scarring of the “ ischæmic ” type is present in the nephrectomy specimen, the operation is likely to alleviate hypertension. In patients with renal artery disease, nephrectomy produces a far higher percentage of successful results than is achieved by arterial surgery.