Renovascular hypertension. Predictability of surgical cure of unilateral renal artery stenosis and bilateral renal artery stenosis.

Records of 75 patients with renal artery disease were studied. Divided renal vein renins and peripheral renins were collected under strict salt and drug intake and postural conditions. The divided renal vein renin ratio and the Vaughan-Laragh combination analysis formula were compared. Scores of both methods were tabulated and compared in each patient with results from surgery. Both methods, when positive, are highly predictive of cure in patients with renal artery disease. Both methods are plagued by significant false-negative rates: 20% for renal vein renin ratio and 33% for the scoring system in patients with unilateral stenosis and 35 and 48%, respectively, in patients with bilateral renal artery stenosis. For these reasons, surgical selection should be based on evaluation of a combination of the clinical presentation, angiographic findings, and renin data and not based on any method of analysis of renin data alone.