Irreversible Renal Failure Secondary to Hypertension Induced by Oral Contraceptives

Oral contraceptive therapy was responsible for two episodes of severe hypertension in a young woman. On the second occasion she developed malignant arteriolar nephrosclerosis that progressed to end-stage renal failure before the contraceptive therapy was stopped. She is now well, requiring no antihypertensive medications, after maintenance hemodialysis, bilateral nephrectomy, and kidney transplantation. The implications of this rare but not unexpected complication from the casual use of hormonal contraceptives are discussed.