December 1966

Malignant Hypertension Following Thrombosis of a Renal Artery

Author Affiliations

From the Department of Surgery, Vanderbilt University School of Medicine and Vanderbilt University Hospital, Nashville.

Arch Surg. 1966;93(6):962-966. doi:10.1001/archsurg.1966.01330060106011

INTEREST in the hypertensive effect of renal artery stenosis dates back to the work of Katzenstien and of Janway in the early 1900's. However, it was not until some 25 years later that the experiments of Goldblatt established the effect of the ischemic kidney on blood pressure. Additional work by others established a relationship between the ischemic kidney, renin, and angiotensin. Recently angiotensin and renal ischemia have been implicated not only as etiologic factors in hypertension, but in other profound metabolic effects. Several authors have shown that angiotensin is related to the secretion of aldosterone presumably in the normal as well as in pathologic states.1-3 In addition definite effects on renal tubular function have been suggested.3,4 In the past few years an association has been noted between renovascular hypertension (particularly malignant hypertension), hypokalemia, and hyperaldosteronism in patients without primary adrenal pathology.5-11 In approximately half of these cases,

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