Renal function changes following surgery for vascular hypertension.

INCREASED systemic blood pressure due to occlusive renal arterial disease is a potentially reversible form of diastolic hypertension. The offending anatomic lesion usually consists of narrowing or occlusion of the renal artery or its primary branches by atheromatous plaques, but it may be of other origin, either congenital or acquired. 1 The surgical goal in such cases is to preserve functional kidney tissue, whenever possible, with arterial revascularization by endarterectomy, angioplasty, or bypass graft. 2-7 Nephrectomy is performed only when these latter procedures are not technically feasible or when the involved kidney is nonfunctional. Although renovascular surgery or nephrectomy may result in blood pressure reduction, little information is available regarding renal functional changes in such cases following surgery. In the patients reported herein, long-term observations indicated that significant sustained blood pressure reduction was accomplished in 12 of 15 subjects treated by renal artery bypass or nephrectomy. It is the