[A case of renovascular hypertension with normalized blood pressure despite interval progression of stenosis of the bilateral renal arteries].

We report here a unique case of renovascular hypertension(RVH) showing spontaneously normalized blood pressure(BP) after progression of a stenosis of the renal arteries for 16 years. The patient was a 41-year-old man. At the age of 25, he developed drug-resistant hypertension with hypokalemia, hyperreninemia and severe stenosis of the right renal artery, and was diagnosed with RVH. He soon discontinued medication without medical advice. At age 40, he developed pons infarction and his aortography showed progression of the stenosis to the bilateral renal arteries. However, his BP along with the levels of plasma potassium and renin activity were normalized and his renal function was preserved. Renal scintigraphy revealed a significant size difference between the bilateral kidneys. We assume that the hypotrophic changes in the ischemic kidneys counterbalanced the reduction in renal blood flow.