Hypertension Produced by Unilateral Renal Disease

Abstract

There is ample reason to believe that, in man, reduced arterial flow to one kidney may result in hypertension. This is evidenced by many reports of long-term reversion to normotension after nephrectomy,^1-12 and by some more recently reported short-term results after plastic surgical procedures upon stenotic renal arteries.^13-15 The underlying mechanism whereby hypertension is brought about in these situations, however, remains unknown. In the period immediately following Butler's initial report of restoration of normotension after removal of a diseased kidney,¹⁶ many nephrectomies were performed, without benefit to the patients in most instances.^17-19 The best results achieved in any of the larger series of cases disclosed that only 30% of the patients had improved. In the past decade further procedures have been devised to evaluate whether or not a morbid kidney is responsible for the hypertension present. It is believed by the authors that (1) proper utilization