Control of Hypertension and Reversal of Renal Failure in Scleroderma

Abstract

MALIGNANT hypertension and rapid deterioration in renal function often occur in systemic scleroderma. Since medical therapy of this hypertension is frequently ineffective,^{1 2 3 4 5} and since the renal failure is considered irreversible,^{4 , 6 , 7} bilateral nephrectomy has been advocated.^{1 2 3 4 5 , 8 9 10} In the case of scleroderma with oliguric renal failure and malignant hypertension reported below, control of blood pressure by drugs made nephrectomy unnecessary. Six months of management by hemodialysis of presumed end-stage renal failure and pharmacologic control of blood pressure were followed by remarkable spontaneous recovery of renal function.This case and review of the literature suggest that nephrectomy should be postponed until maximal medical . . .