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[Renovascular hypertension].

N Ichimaru1, K Toki, T Tanaka

  • 1Department of Urology, Osaka University Medical School.

Hinyokika Kiyo. Acta Urologica Japonica
|December 7, 2000
PubMed
Summary

Renovascular hypertension (RVH) management has evolved with advances in diagnosis and treatment. Percutaneous transluminal angioplasty (PTA) is now the preferred initial therapy, with surgery reserved for cases where PTA is unsuccessful.

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Area of Science:

  • Nephrology
  • Cardiology
  • Vascular Surgery

Background:

  • Renovascular disease is a leading cause of secondary hypertension.
  • Management strategies for renovascular hypertension (RVH) have advanced significantly.
  • An aggressive diagnostic and treatment approach is now recommended for RVH.

Purpose of the Study:

  • To review the management of renovascular hypertension (RVH) over a 40-year period.
  • To identify the primary causes and treatment modalities for RVH.
  • To evaluate the effectiveness of different interventions for RVH.

Main Methods:

  • Retrospective analysis of 95 patients with renovascular hypertension (RVH) diagnosed between 1958 and 1999.
  • Review of medical records detailing patient demographics, underlying causes, and treatments received.

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  • Categorization of treatments including surgical reconstruction, nephrectomy, autotransplantation, and percutaneous transluminal angioplasty (PTA).

    • Main Results:

    • The most common causes of RVH were fibromuscular dysplasia (34%), arteriosclerosis (26%), and aortitis (12%).
    • Of 79 patients treated, 92 kidneys underwent intervention.
    • Percutaneous transluminal angioplasty (PTA) was performed in 25 cases and is now the primary treatment, with surgery reserved for PTA failures.

    Conclusions:

    • Fibromuscular dysplasia and arteriosclerosis are key etiologies of RVH.
    • Percutaneous transluminal angioplasty (PTA) has emerged as the preferred initial treatment for renovascular hypertension (RVH).
    • Surgical intervention and pharmacotherapy remain important for specific patient groups or treatment failures.