Renal Function During Long-Term Treatment of Hypertension with Minoxidil

Abstract

The effect of long-term blood pressure control on renal function in 41 patients with refractory hypertension by using minoxidil, sympathetic suppressants, and diuretics continuously for 6 mo. to 7 1/2 yr was studied. In 15 of 32 patients with benign hypertension, the serum creatinine concentration increased by more than 1 mg/dl, with 9 of 15 requiring hemodialysis. Analysis of 1/serum creatinine vs. time plots indicated that the use of minoxidil delayed the onset of endstage renal failure in some patients for up to 6 yr. In the remaining 17 patients with benign hypertension, renal function remained stable with no decreases greater than 2 mg/dl. Four of 9 patients presenting with malignant hypertension had marked and sustained improvement in renal function, although 3 initially required hemodialysis. The mean serum creatinine concentration in these 4 patients fell from 9.7 to 2.9 mg/dl. Impressive renal functional improvement may occur with minoxidil use in some patients with malignant hypertension.