Role of nephrectomy in hypertension with renal artery occlusion

Nephrectomy was performed in 12 patients with complete renal artery occlusion and hypertension refractory to intensive medical therapy. Renal vein renin was assayed preoperatively in 10 of the 12, and in 8 the ratio was at least 1.5:1, strongly suggesting renal artery occlusion on the side with the higher concentration of renin in venous blood. In two patients peripheral plasma renin activity was very high before operation, then decreased greatly afterwards. Three patients were considered cured and eight improved (overall improvement rate, 92%). The results were predicted by the renin ratio.