Some Aspects of Occlusive Renal Arterial Disease in Man

Abstract

A review of the past six years' experience with the surgical treatment of hypertension associated with occlusive renal arterial disease has shown that in about 60 per cent of patients diastolic hypertension remitted, and in about 16 per cent arterial pressure was greatly reduced. In a small group of patients not operated upon, antihypertensive drugs were found to be as effective as in patients with essential hypertension; this suggests a neurogenic component in this type of renal hypertension. Revascularization procedures in patients with unilateral renal arterial stenosis usually lessened disparities in glomerular filtration rate of the two kidneys but did not eliminate them. Postoperatively, solute and water excretions of the repaired kidney usually exceeded those of the unaffected side even though preoperatively they had been much less. In a few patients, information concerning the natural history of renal arterial diseases shows that atherosclerosis need not necessarily cause progressive stenosis over periods as long as one year, and that the nonatherosclerotic lesions, segmental mural fibrosis and intimal sclerosis, once established, can exist without apparent change for as long as three years.