[Renovascular hypertension]

Renovascular disease frequently escapes clinical diagnosis. Critical stenosis of the renal artery causes hypoperfusion of the kidney which in turn is the cause of renovascular hypertension and ischaemic nephropathy. Detection of renovascular disease in the population of hypertonic patients should be based on clinical symptoms. In a selected group one of the imaging methods can be used. The increasing number of patients with stenosis of the renal artery is indicated for percutaneous transluminal angioplasty or surgical revascularization as the function of the ischaemized kidney is a risk. Medicamentous treatment of hypertension, which is usually successful, is indicated in patients with atherosclerosis with a history of cardiovascular complications or a high risk of the latter. The contribution and risk of different therapeutic methods must be considered individually with regard to the clinical condition as well as the findings on the blood vessels.

A unique contribution of angioplasty in stenosis of the renal artery or surgical revascularization is the possibility to improve renal haemodynamics and thus renal function. Prevention of ischaemic nephropathy calls for early diagnosis of renovascular disease.