Curable Renal Hypertension— Renin, Marker or Cause?

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Abstract
The identification of patients who might have curable hypertension secondary to unilateral renal disease has been aided by the application of differential renal function tests as first introduced by Howard.1However, despite numerous modifications,2these tests have proved to have limitations both in their application and in predicting operative curability. An example of this latter problem appears in a recent issue ofThe Journalin a paper by Fair and Stamey.3This group of investigators, who have pioneered in the application of such tests, now demonstrate that despite prior conclusions to the contrary,4hypertension in patients with unilateral, but segmental, renal ischemia can represent a true "Goldblatt effect," and cure can be accomplished even though hemodynamic and excretory function may be nearly normal in the affected kidney. The other side of this coin is presented in another paper by Palmer5in the same issue of

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