A Follow‐up Study of Hypertensive Patients after Operative Treatment of Unilateral Renovascular or Renal Disease

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Abstract
A study of 44 hypertensive patients with unilateral renovascular or renal parenchymal disease is presented. All patients underwent corrective surgery. Of 44 operated patients, 5 were not followed-up. The remaining 39 patients constitute the study population. The effects of surgery on the hypertensive state was evaluated in 35 patients, whereas 4 died less than 2 mo. after the operation. Follow-up studies were carried out at 8-60 mo. after the operation. The average period of observation was 32 mo.; 24 patients were observed for more than 2 yr. As a group, the patients had severe hypertension with extensive target organ damage and widespread atherosclerosis. A rigorous selection process was applied, and an unsatisfactory response to medical management was important. In most cases, renovascular lesions were atherosclerotic, with only 2 cases of fibromuscular dysplasia. Unilateral nephrectomy was performed in 32 patients, whereas 7 underwent reconstructive vascular surgery. Of 35 patients, 22 (63%) were cured, 8 (23%) improved and 5 (14%) unaltered. A gratifying regression of hypertensive lesions in target organs was observed in patients who were cured or improved by surgery. The frequency and severity of postoperative complications were related to the presence of extrarenal vascular disease.

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