J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 3682KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 80(9): 848-853, 1979

Original article

RENOVASCULAR HYPERTENTION ASSOCIATED WITH CONTRALATERAL MARKED NEPHROSCLEROSIS REPORT OF A CASE

*) The 2nd Department of Surgery, Faculty of Medicine,  University of Tokyo
**) Department of Thoracic Surgery, Faculty of Medicine, University of Tokyo

Hitoshi Kanamaru*), Yusuke Tada*), Akira Ueno**), Taijun Go**)

A successful operation of a case with renovascular hypertention associated with marked nephrosclerosis was reported. The patient was 38-year-old male and had been hypertensive for about nineteen years before the diagnosis was established. Although almost all investigations indicated for immediate operative cure, it was decided not for surgery because of lacking significant difference between the right and the left renal vein plasma renin activity. The renal function on the "nonstenotic" side (right) began to be deteriolated by rapidly progressing nephrosclerosis with uncontrolable hypertention. The operation was carried out under the condition of the non-functioning right kidney. The hypertention and the renal function were greatly improved by the repair of the left renal arterial stenosis. The cause of the stenosis was revealed to be intimal fibroplasia complicated with mural thrombosis.
This case suggests that medical treatment for renovascular hypertention does not always benefit the renal function or stabilize the renin-angiotensin system and that the operative indication should not be determined solely based on plasma renin activity.

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