Reversible renal failure in malignant hypertension

Acute renal failure requiring dialysis to sustain life may be due to malignant hypertension. If the blood pressure is controlled during a period of dialysis, then it is possible that the renal lesions may heal, with some recovery of renal function. This report describes eight patients with acute renal failure due to malignant hypertension who required temporary dialysis. In all eight cases adequate control of blood pressure was achieved and all recovered renal function such that dialysis could be discontinued. The longest period of follow-up was five years, and one patient achieved a creatinine clearance of 23 ml/min. Renal histology, available in five cases, showed changes of malignant hypertension only, with no evidence of other renal lesions. A review of the literature is presented and the potentially reversible nature of acute oliguric renal failure due to malignant hypertension is emphasized.