Editorial

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Abstract
Recently it has been claimed that a high percentage of the entire hypertensive population may be accounted for by potentially curable unilateral renal disease. Validation or refutation of this seemingly extravagant claim places a new responsibility on physicians involved in care of hypertensive patients. Because the mechanisms involved in chronic Goldblatt hypertension remain obscure, there is no truly specific test for this condition. Angiography, though necessary preoperatively, provides no functional information. Neither this nor clearances are applicable to the large numbers of suspects. The isotope renogram seems to have serious limitations as a screening procedure. Modified intravenous pyelography (rapid injection, no abdominal compression and timed minute-sequence films) has proven to be a most important screening test which may be applied with confidence to all hypertensive patients. The technique provides important anatomic and functional information about each kidney. With this technique in a study of 200 patients our data indicate greater than 90% accuracy in detecting patients with significant unilateral disease. At present this approach represents a most valuable screening test applicable to all hypertensive patients. This approach can identify nearly all of the probably one or 2% of the hypertensive population who have correctable renal hypertension. It will spare the great majority of unnecessary procedures.