High incidence of hypertension in older patients after unilateral nephrectomy. A retrospective study

Twenty-six normotensive patients, who underwent unilateral nephrectomy for nontumoral urological diseases, were reevaluated. The mean postoperative follow-up period was 13.8 +/- 0.7 years. Eleven patients developed hypertension, and 15 patients remained normotensive. The former were 47.1 +/- 3.3 years old, and the latter 36.5 +/- 2.9 years old at the time of nephrectomy (P less than 0.02). The mean preoperative systolic blood pressure was higher in the group of 11 hypertensive patients (126.7 +/- 2.4 mm Hg) than in the 15 normotensive patients (118.2 +/- 2.9 mm Hg), P less than 0.04. Preoperative diastolic blood pressure was similar in the two groups (77.8 +/- 1.5 vs. 75 +/- 2 mm Hg). Preoperative and follow-up serum creatinine levels were similar in both groups. Mean creatinine clearance (Ccr) at the time of follow-up was not significantly different in the hypertensive patients compared with the normotensive patients. One patient developed proteinuria and chronic renal failure (Ccr of 31 ml/min). Two other patients with normal Ccr had a daily protein excretion of 840 and 2,000 mg/24 h, respectively. The incidence of hypertension, after nephrectomy, of 75% in patients greater than 55 years old seems to be significantly higher than the 30% reported in an aged-matched normal Israeli population. This did not apply to the patients less than 55 years old. In most of the cases, long-term follow-up did not reveal significant uninephrectomy induced changes in renal function.