The role of nephrectomy of the atrophic kidney in bearers of renovascular hypertension.

PURPOSE: Evaluation of the beneficial effect of nephrectomy of the atrophic kidney on blood pressure (BP) and renal function.

MATERIALS AND

METHODS

A retrospective study of 51 patients with renovascular hypertension (RVH), bearers of atrophic kidney due to severe stenosis or occlusion of the renal artery. Average age was 47.1 +/- 15 years, the median creatinine clearance was 54 mL/min, average systolic BP (SBP) 149.6 +/- 22.5 mm Hg, average diastolic BP (DBP) 90.8 +/- 17 mm Hg and the median number of hypotensors 3 (1 to 5) per patient per day. Blood pressure and serum creatinine were analyzed from 12 to 60 months after the nephrectomy.

RESULTS

There was a significant improvement in the average SBP in the periods from 12 to 36 months (p < or = 0.028) and for the average DBP from 12 to 48 months after the nephrectomy (p < or = 0.045), accompanied by a significant reduction in the use of hypotensors from 12 to 48 months (p < 0.05). One year after the nephrectomy, there was a 69% improvement in blood pressure and 63.8% improvement in renal function of patients.

CONCLUSION

The removal of atrophic kidney in patients with RVH is a safe procedure which presents benefits for the control of arterial hypertension and renal function in bearers of renovascular hypertension.