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October 23, 1972

Malignant Hypertension Following Renal Artery Branch ObstructionEvidence for High Renin Production From the Ischemic Area

JAMA. 1972;222(4):457-459. doi:10.1001/jama.1972.03210040029008

Occlusion of a renal artery branch with subsequent partial renal infarction resulted in high renin production from the ischemic part of the kidney and malignant hypertension. Absence of overall ischemia from the affected kidney prevented development of a pattern of increased concentration of nonabsorbable solutes (ie, creatinine and para-aminohippuric acid), although total urine flow was decreased by reduction of renal excretory mass. Renin activity was at least tenfold higher in the ischemic area than in the normal kidney and manifested itself clinically by a 1.7 to 1 difference in the preoperative renal vein renin values between the affected and nonaffected kidneys. Removal of the affected kidney resulted in a "cure" of the malignant hypertension.