Restoration of renal function after bilateral renal artery occlusion

Five patients had anuric renal failure caused by occlusion of the main renal arteries. All had a background of controlled hypertension, but in three patients, hypertension accelerated in the months before anuria. Extensive atherosclerotic disease was clinically evident in the peripheral (3/5), coronary (4/5), and cerebral (1/5) vessels. Identifiable precipitating events preceded the development of anuria in four patients. Although the use of renal ultrasonogram and scintiscan was suggestive, angiography was essential to establish the diagnosis after a brief period of maintenance hemodialysis. Renal artery revascularization performed as long as 38 days after the onset of anuria resulted in restoration of kidney function.