Renal artery occlusion and malignant hypertension in polycystic kidney disease

A patient with polycystic kidneys is presented, in whom obliteration of a renal artery led to the development of high renin malignant hypertension. During chronic hemodialysis 3 years later the patient had normal renin values and the blood pressure became volume-dependent. It is concluded that the occurrence of malignant hypertension and/or elevated renin values in patients with polycystic kidney disease should lead to the search for a coexisting renal artery stenosis or occlusion.