Renal segmental infarction: a cause of reversible malignant hypertension

Five cases of accelerated or malignant hypertension which occurred in young adults within a few weeks of renal segmental infarction are reported here. Such infarction appears to give rise to a form of renovascular hypertension, the severity and sudden onset of which distinguishes it from renal fibrodysplasia, which is commonly observed in this age group. In three cases hypertension was corrected by nephrectomy. In two cases several months medical treatment was associated with remission of hypertension without surgery. It is therefore suggested that hypertension due to renal infarction, unlike that caused by fibromuscular dysplasia, may be managed by prolonged medical treatment.