The current role of surgical revascularization for combined renovascular hypertension and renal insufficiency.

The number of elderly patients presenting with the difficult combination of renovascular hypertension and deteriorating renal function is increasing. The majority of these patients have diffuse cardiovascular disease requiring careful preoperative evaluation and stabilization. Adequate control of hypertension and preservation of renal function frequently requires bilateral renal procedures in addition to aortic replacement in patients with significant aorto-iliac disease or aortic aneurysms. Early and late results continue to justify prompt surgical consultation and revascularization of patients with combined renovascular hypertension and renal insufficiency.