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June 28, 1965

Criteria for Screening the Hypertensive Patient With Renal-Artery Occlusion

Author Affiliations

From the Department of Surgery, St. Mary's Hospital Medical Center, San Francisco.

JAMA. 1965;192(13):1125-1129. doi:10.1001/jama.1965.03080260013004

An orderly search for a surgically correctable vascular lesion is necessary in the diagnostic evaluation of the hypertensive patient. A series of 210 cases were evaluated with a view toward appraising the relative merits of the intravenous pyelogram, radioisotope renogram, renal arteriogram, and differential renal-clearance studies as screening procedures. With a normal intravenous urogram and a normal renogram, one can be reasonably assured that a surgically correctable vascular lesion due to atheroma is not present. When either the pyelogram or the renogram is abnormal, the hypertensive patient should have a renal arteriogram. When an operable vascular lesion is anatomically demonstrated on the arteriogram, the work performance of the individual kidneys should be determined with split renal-clearance studies before the patient is considered as a candidate for vascular-reconstructive surgery.