During a 10 year period 58 patients with renovascular hypertension due to renal artery stenosis were treated surgically. A retrospective analysis of the results was carried out. No perioperative mortalities occurred. Ten percent of the patients developed hypertension again after an average of 27 months. At follow-up (median 65 months), 85% of the patients had normal blood pressure or either no, modest or considerably reduced anti-hypertensive medication. It is concluded that surgical treatment of renovascular hypertension is a safe and effective procedure.

The purpose of the study was to evaluate the effect of surgery for renal artery stenosis in patients with impaired renal function. The design was a retrospective investigation with follow-up. The material consisted of 42 such patients operated at Rigshospitalet between 1980 and 1990. Renal function and blood pressure status was evaluated preoperatively and at follow-up. The perioperative mortality was 5% (n = 2) and morbidity 21% (n = 9). At discharge from hospital renal function was maintained in 38 patients (90%), including three patients who at the time of operation were without diuresis and had been in dialysis for up to 28 days. Twenty-three patients were still alive at postoperative follow-up at a median of 66 months. The cumulative five-year survival was 62%, which was significantly lower than that of a sex- and age-matched population. Eleven patients developed terminal renal insufficiency during the follow-up period. The cumulative preservation of renal function was 77% after five years. In conclusion, reconstruction of the renal arteries in patients with declining renal function and renal artery stenosis or occlusion can save renal function such that dialysis may be avoided in most cases.