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September 1963

Renal Hypertension, Heart Failure, and Azotemia: Report of a Case Treated Successfully by Nephrectomy

Author Affiliations

Department of Urology, Western Reserve University School of Medicine, and the Cleveland Veterans Administration Hospital.

Arch Surg. 1963;87(3):530-533. doi:10.1001/archsurg.1963.01310150166037

Frequent reports have appeared in the urological literature dealing with the diagnosis and treatment of renal hypertension.1-6 Emphasis has been placed on clinical history, intravenous pyelography, divided function studies, renal angiography, and more recently the radioisotope renogram.7 Unexplained flank pain followed by the abrupt onset of severe hypertension naturally alerts the physician to the possibility of segmental or main renal artery thrombosis or embolism, but more often the history is less suggestive or unremarkable. Intravenous pyelograms and tests of total renal function are frequently normal, and divided function studies are subject to considerable error, in both performance and interpretation. Renal angiography, while important in the ultimate preoperative evaluation of the patient with suspected renal hypertension, has certain attendant hazards and should not be used as a routine diagnostic procedure.

In the preoperative evaluation of the patient with renal hypertension it has generally been emphasized that total renal function

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