[Renovascular hypertension--diagnosis and treatment]

The approach and treatment of renovascular hypertension are presented. The study include 65 patients with severe arterial hypertension (31 men and 34 women), mean age 52 years, 26 of them with renovascular hypertension. Along with the usual diagnostic work-up, renal angiography using Seldinger method and renin measurement were performed in all patients through renal vein. Twelve patients underwent renal artery dilatation (PTRA), six patients kidney autotransplantation, and the rest were treated by medications. In nine patients, complete cure or improvement was achieved by PTRA, whereas unsuccessful renal artery dilatation was recorded in three patients. Surgical therapy for renovascular hypertension was used in six patients and proved successful. It is concluded that the earliest possible detection of renovascular hypertension is of utmost importance because this form of arterial hypertension is one of the most common potentially curable types of secondary hypertension. Concerning the methods of treatment, their invasiveness, and differences between various therapeutic procedures, it is important to make an algorithm of treatment for each individual patient.