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- W2028702909 abstract "From 1962 through 1966, 115 patients with renal artery stenosis were studied; forty-three were operated on, based on positive findings from split function studies, intravenous pyelograms, angiotensin tests and renal vein blood “pressor material” or renin assay. Eighteen had unilateral nephrectomy, twenty-five corrective vascular surgery. Immediate postoperative results indicated that five were normotensive, six showed marked improvement, twelve showed slight improvement, seventeen were unimproved and three were dead. The tests did not clearly distinguish the eleven patients who did well but renal function was slightly less in the group that did poorly and these patients tended to be older, to have a longer duration of hypertension and a greater incidence of diabetes. Type of surgery was also a factor, nephrectomy giving better results. At the end of 1967, with follow-ups ranging from one to six years, the number of dead had risen to fifteen (35 per cent) with seven (16 per cent) unimproved; average ages were fifty and fifty-five years, respectively. In contrast, twelve were now either normotensive or showed marked improvement; their ages averaged thirty-eight and forty-six years, respectively. Eleven patients had had vascular accidents including several with good blood pressure response. Follow-up data available in sixty-nine of the seventy-two unoperated patients indicated that 40 per cent were dead. The results emphasize that establishing the fact that hypertension is caused by renal ischemia is an insufficient basis on which to predict a successful surgical outcome. Age and overall vascular status seem to be major considerations in determining survival. It is suggested that even when definite renal ischemia is demonstrated in patients over fifty to fifty-five who have other major atherosclerotic disease and diabetes, surgery should be considered only if progression of the hypertensive disease cannot be controlled by medical therapy." @default.
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- W2028702909 date "1969-08-01" @default.
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- W2028702909 title "Renal artery stenosis and hypertension" @default.
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- W2028702909 doi "https://doi.org/10.1016/0002-9343(69)90145-4" @default.
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