WHEREAS HEREAS the modern medical management of hypertension offers a much brighter outlook than it formerly did for many patients, surgical intervention is indicated for those who have unilateral parenchymal or vascular renal disease. The development of this type of surgical aid has stemmed from the intensive investigation that has clarified some aspects of the pathogenesis of hypertension, even though its etiology is still unknown. Of prime importance were the experiment of Goldblatt and his colleagues,1 who confirmed the theories of Fahr2 that renal ischemia is one cause of elevated blood pressure, and the demonstration of the angiotensin mechanism.3,4 Thus, surgical correction of renal ischemia by means of bypass repair of a narrowed renal artery results in decrease in systemic arterial blood pressure, although the persistence of such a fall is variable.
All reports of renovascular corrective surgery have been in patients who have both kidneys; the
KNIGHT A. Renovascular Hypertension With a Congenital Solitary Kidney. Arch Intern Med. 1966;118(6):580-583. doi:10.1001/archinte.1966.00290180056011