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Abstract

Renal parenchymal disease and renovascular abnormalities are the most common causes of secondary hypertension. In clinical practice, a search for renal disease (i.e., proteinuria, abnormal urinary sediment, increased serum creatinine) should be undertaken in the presence of any newly diagnosed hypertension; however, only selected patients should be screened for renovascular disease. In recent years, the challenge in the management of patients with renal parenchymal disease has focused on the influence of strict control of hypertension on the rate of deterioration of renal function with time. In several experimental models, the use of antihypertensive agents has proved efficient in preventing the decline in renal function as well as the extent of glomerulosclerosis; interestingly, all antihypertensive medications were not equally effective in this regard. A number of questions remain unsettled in humans: Can adequate control of blood pressure slow down renal deterioration? Which drug should be used? What is the optimal level of arterial pressure? Although ischemic renovascular disease has recently emerged as an important cause of renal failure, the potential of revascularization to improve or preserve renal function is still a matter of debate.

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References

  1. Bonomini V, Campieri C, Scolari MP, Vangelista A: Hypertension in acute renal failure. Contrib Nephrol 54: 152–157, 1987.

    PubMed  CAS  Google Scholar 

  2. Johnston PA, Davison AM: Hypertension in adults with idiopathic glomerulonephritis and normal serum creatinine. A report from the MRC glomerulonephritis registry. Nephrol Dial Transplant 8: 20–24, 1993.

    Article  PubMed  CAS  Google Scholar 

  3. Kincaid-Smith P: Malignant hypertension. J Hypertens 9: 893899, 1991.

    Google Scholar 

  4. Mogensen CE: Long-term antihypertensive treatment inhibiting progression of diabetic nephropathy. Br Med J 285: 685686, 1982.

    Google Scholar 

  5. Parving HH, Smidt UM, Andersen AR, Sveendsen PAA: Early aggressive antihypertensive treatment reduces rate of decline in kidney function in diabetic nephropathy. Lancet 1: 1175–1178, 1983.

    Article  PubMed  CAS  Google Scholar 

  6. Mathiesen ER, Hommel E, Giese J, Parving HH: Efficacy of captopril in postponing nephropathy in normotensive insulin-dependent diabetic patients with microalbuminuria. Br Med J 303: 81–86, 1991.

    Article  CAS  Google Scholar 

  7. Brazy PC, Stead WW, Fitzwilliam JF: Progression of renal insufficiency: role of blood pressure. Kidney Int 35: 670–674, 1989.

    Article  PubMed  CAS  Google Scholar 

  8. Bergstrom J, Alvestrand A, Bucht H, Gutierez A: Progression of chronic renal failure in man is retarded with more frequent clinical follow-ups and better blood pressure control. Clin Nephrol 25: 1–6, 1986.

    PubMed  CAS  Google Scholar 

  9. Alberti O, Locatelli F, Graziani G, and the Northern Italian Cooperative Study Group: Hypertension and chronic renal insufficiency: the experience of Northern Italian Cooperative Study Group. Am J Kidney Dis 21 (Suppl 2): 124–130, 1993.

    Google Scholar 

  10. Anderson S, Rennke HG, Brenner BM: Therapeutic advantage of converting enzyme inhibitors in arresting progressive renal disease associated with systemic hypertension in the rat. J Clin Invest 77: 1993–2000, 1986.

    Article  PubMed  CAS  Google Scholar 

  11. Smith WGJ, Dharmasena AD, El Nahas AM, Thomas DM, Coles GA: Short-term effect of captopril on renal haemodynamics in chronic renal failure. Nephrol Dial Transplant 4: 696–700, 1989.

    PubMed  CAS  Google Scholar 

  12. Rodicio JL, Alcazar JM, Ruilope LM: Influence of converting enzyme inhibition on glomerular filtration rate and proteinuria. Kidney Int 38: 590–594, 1990.

    Article  PubMed  CAS  Google Scholar 

  13. Zucchelli P, Zuccala A, Borghi M, Fusaroli M, Sasdelli M, Stallone C, Sanna G, Gaggi R: Long-term comparison between captopril and nifedipine in the progression of renal insufficiency. Kidney Int 42: 452–458, 1992.

    Article  PubMed  CAS  Google Scholar 

  14. Aperloo AJ, DeZeeuw D, DeJong PE: Short-term antiproteinuric response to antihypertensive treatment predicts long-term GFR decline in patients with non-diabetic renal disease. Kidney Int 45 (Suppl 45): S174–S178, 1994.

    Google Scholar 

  15. Hannedouche T, Landais P, Goldfarb B, El-Esper N, Fournier A, Godin M, Durand D, Chanard J, Mignon F, Suc JM, Grünfeld JP: Blood pressure control in non diabetic chronic renal failure: a prospective controlled study comparing ACE inhibition versus conventional antihypertensive therapy. Br Med J 309: 833–837, 1994.

    Article  CAS  Google Scholar 

  16. Brazy PC, Fitzwilliam JF: Progressive renal disease: role of race and antihypertensive medications. Kidney Int 37: 1113–1119, 1990.

    Article  PubMed  CAS  Google Scholar 

  17. Vertes V, Cangiano JL, Berman LB, Gould A: Hypertension in end-stage renal disease. N Engl J Med 280: 978–981, 1969.

    Article  PubMed  CAS  Google Scholar 

  18. Charra B, Calemard E, Ruffet M, Chazot C, Terrat JC, Vanel T, Laurent G: Survival as an index of adequacy of dialysis. Kidney Int 41: 1286–1291, 1992.

    Article  PubMed  CAS  Google Scholar 

  19. Esbach JW, Aquiling T: The long-term effect of recombinant human erythropoïetin on the cardiovascular system. Clin Nephrol 38: S98–S103, 1992.

    Google Scholar 

  20. Davis BA, Crook JE, Vestal RE, Oates JA: Prevalence of renovascular hypertension in patients with grade III or IV hypertension retinopathy. N Engl J Med 301: 1273–1276, 1979.

    Article  PubMed  CAS  Google Scholar 

  21. Isles C, Brown JJ, Cumming AMM: Excess smoking in malignant-phase hypertension. Br Med J 1: 579–581, 1979.

    Article  PubMed  CAS  Google Scholar 

  22. Ramos O: Malignant hypertension: the Brazilian experience. Kidney Int 25: 209–217, 1984.

    Article  Google Scholar 

  23. Elliott WJ, Weber RR, Nelson KS, Oliner CM, Fumo MT, Gretler DD, McCray GR, Murphy MB: Renal and hemodynamic effects of intravenous fenoldopam versus nitroprusside in severe hypertension. Circulation 81: 970–977, 1990.

    Article  PubMed  CAS  Google Scholar 

  24. Mourad G, Mimran A, Mion C: Recovery of renal function in patients with accelerated malignant nephrosclerosis on maintenance dialysis with management of blood pressure by captopril. Nephron 41: 166–169, 1985.

    Article  PubMed  CAS  Google Scholar 

  25. Smith HW: Hypertension and urologic disease. Am J Med 4: 724–743, 1947.

    Article  Google Scholar 

  26. Belman BA, Kropp KA, Simon NM: Renal pressor hypertension secondary to unilateral hydronephrosis. N Engl J Med 278: 1133–1136, 1968.

    Article  PubMed  CAS  Google Scholar 

  27. Wanner C, Lüscher TF, Schollmeyer P, Vetter W: Unilateral hydronephrosis and hypertension: cause or coincidence? Nephron 45: 236–241, 1987.

    Article  PubMed  CAS  Google Scholar 

  28. Clark WR, Malek RS: Ureteropelvic junction obstruction. Observations on the classic type in adults. J Urol 138: 276–279, 1987.

    PubMed  CAS  Google Scholar 

  29. Vaughan ED, Sosa RE: Hypertension and hydronephrosis. In: JH Laragh, BM Brenner, eds, Hypertension: Pathophysiology, Diagnosis, and Management. Raven Press, New York, pp 1601–1607, 1990.

    Google Scholar 

  30. Kincaid-Smith P: Vascular obstruction in chronic pyelonephritic kidneys. Lancet 2: 1263–1268, 1955.

    Article  Google Scholar 

  31. Bailey RR, McCrae CU, Maling TMJ, Tisch G, Little PJ: Renal vein renin concentration in the hypertension of unilat eral reflux nephropathy. J Urol 120: 21–23, 1978.

    PubMed  CAS  Google Scholar 

  32. Shapiro AP, Sapira JD, Scheib ET: Development of bacteriuria in hypertensive population. A 7-year follow-up study. Ann Intern Med 74: 861–868, 1971.

    Article  PubMed  CAS  Google Scholar 

  33. Batzenschlager A, Weill-Bousson M, Guerbaoui M: Hypoplasie segmentaire aglomérulaire du rein. Complication hypertensive et résultats de la chirurgie. Sem Hop Paris 50: 609–613, 1974.

    PubMed  CAS  Google Scholar 

  34. de Jong PE, van Bockel JH, de Zeeuw D: Unilateral renal 1988. renal artery stenosis of 55. Mann SJ, Pickering TG: Detection of renovascular hyperten the fibrodysplasia type. Ann Intern Med 110: 437–445, 1989.

    Article  PubMed  Google Scholar 

  35. Sufrin G: The Page kidney: a correctable form of arterial hypertension. J Urol 113: 450–454, 1975.

    PubMed  CAS  Google Scholar 

  36. McCune TR, Stone WJ, Breyer JA: Page kidney: case report and review of the literature. Am J Kidney Dis 18: 593–599, 1991.

    PubMed  CAS  Google Scholar 

  37. Elias AN, Anderson GH, Dalakos TG, Streeten DHP: Renin angiotensin involvement in transient hypertension after renal injury. J Urol 119: 561–562, 1978.

    PubMed  CAS  Google Scholar 

  38. Stockigt JR, Sacharias N, Wood AS, Dugdale LM: Segmental Predictive value renin sampling and partial nephrectomy in renal hypertension. Arch Intern Med 136: 1297–1298, 1976.

    Article  PubMed  CAS  Google Scholar 

  39. Sterns RH, Rabinowitz R, Segal AJ, Spitzer RM: Page Hypertension caused by chronic subcapsular hematoma. and renovas. Arch Intern Med 145: 169–171, 1985.

    Article  PubMed  CAS  Google Scholar 

  40. Knapp PM, Kulb TB, Lingeman JE: Extracorporeal hematoma. J Urol 139: 700–60.

    Google Scholar 

  41. Lingeman JE, Woods JR, Toth PD: Blood pressure changes following extracorporeal shock wave lithotripsy and other forms of treatment for nephrolithisasis. JAMA 263:1789-1794, 1990.

    Google Scholar 

  42. Madrazo A, Schwartz G, Churg J: Radiation nephritis. A re view. J Urol 114: 822–827, 1975.

    PubMed  CAS  Google Scholar 

  43. Luston RW: Radiation nephritis: a long-term study of 54 pa tients. Lancet 2: 1221–1225, 1961.

    Article  Google Scholar 

  44. Juncos LI, Carrasco Dueüas S, Cornejo JC, Broglia CA, Cejas DeBoo T, Thien H: Long-term enalapril and hydrocholorothiazide in radiation nephritis. Nephron 64: 249–255, 1993.

    Article  PubMed  CAS  Google Scholar 

  45. Jacobson HR: Ischemic renal disease: an overlooked clinical thrombosis caused by entity? Kidney Int 34: 729–743, 1988.

    Article  PubMed  CAS  Google Scholar 

  46. Holley KE, Hunt JC, Brown AL, Kincaid OW, Sheps SG: C, Nochy D, Renal artery stenosis. Am J Med 37: 14–22, 1964.

    Article  PubMed  CAS  Google Scholar 

  47. Harding MB, Smith LR, Himmelstein SI, Harrison K, Phillips Kidney Int 29: 1011–1111.

    Google Scholar 

  48. Olin JW, Melia M, Young JR, et al.: Prevalence of atheroscle stenosis. renal artery stenosis in patients with atherosclerosis else- Galceran J, Alsina where. Am J Med 188: 46–51, 1990.

    Google Scholar 

  49. Mimran A, Ribstein J, Du Cailar G: Converting enzyme in hibitors and renal function in essential and renovascular hypertension. Am J Hypertens 4:7s-14s, 1991.

    Google Scholar 

  50. Hricik D, Browning PJ, Kopelman R, Goorno WE, Madias NE, Dzau VJ: Captopril-induced functional renal insufficiency in patients with bilateral renal-artery stenoses or renal-artery stenosis in a solitary kidney. N Engl J Med 308: 373–376, 1983.

    Article  PubMed  CAS  Google Scholar 

  51. Zimbler MS, Pickering TG, Sos TA, Laragh JH: Proteinuria in renovascular hypertension and the effects of renal angioplasty. Am J Cardiol 59: 406–408, 1987.

    Article  PubMed  CAS  Google Scholar 

  52. Goormastic M: Trends in surgical revascularization for renal 77. artery disease. JAMA 257: 498–501, 1987.

    Article  PubMed  Google Scholar 

  53. Schreiber MJ, Pohl MA, Novick AC: The natural history of atherosclerotic and fibrous renal artery disease. Urol Clin North Am 11: 383–392, 1984.

    PubMed  CAS  Google Scholar 

  54. Mailloux LU, Bellucci AG, Mossey RT, Napolitano B, Moore T, Wilkes BM, Bluestone PA: Am J Med 84:855-862,

    Google Scholar 

  55. Mailloux LU, Bellucci AG, Mossey RT, Napolitano B, Moore T, Wilkes BM, Bluestone PA: parenchymal disease with contralateral sion. State of the Art: 1992. Ann Intern Med 117: 845–853, 1992.

    Article  Google Scholar 

  56. Libertino JA, Beckman CF: Surgery and percutaneous angioplasty in the management of renovascular hypertension. Urol Clin North Am 21: 235–243, 1994.

    PubMed  CAS  Google Scholar 

  57. Atkinson AB, Brown JJ, Cumming AMM, Fraser R, Lever AF, Leckie BJ, Morton JJ, Robertson JIS: Captopril in renovascular hypertension: long-term use in predicting surgical outcome. Br Med J 284: 689–693, 1982.

    Article  CAS  Google Scholar 

  58. Pickering TG, Sos TA, Vaughan ED, et al.: and changes of renin secretion in hypertensive patients with unilateral renovascular disease undergoing successful renal kid angioplasty. Am J Med 76:398-404, 1984. ney.

    Google Scholar 

  59. Hunt JC, Sheps SG, Harrisson EG, et al.: Renal cular hypertension: a reasoned approach to diagnosis and shock management. Arch Intern Med 133: 988–999, 1974.

    Article  PubMed  CAS  Google Scholar 

  60. Hollifield JW, DuPont WD: Renovascular hypertension: anatomic and renal function changes during drug therapy. Arch Surg 116: 1408–1415, 1981.

    Article  PubMed  Google Scholar 

  61. Franklin SS, Smith RD: A comparison of enalapril plus hydrochlorothiazide with standard triple therapy in renovascular hypertension. Nephron 44 (Suppl 1): 73–82, 1986.

    Article  PubMed  Google Scholar 

  62. Ribstein J, Mourad G, Mimran A: Contrasting effects of captopril and nifedipine on renal function in renovascular hypertension. Am J Hypertens 1: 239–244, 1988.

    Article  PubMed  CAS  Google Scholar 

  63. Postma CT, Hoefnagels WHL, Barentsz JO, T: Occlusion of unilateral stenosed renal arteries-relation to medical treatment. J Hum Hypertens 3: 185–190, 1989.

    PubMed  CAS  Google Scholar 

  64. Shaw AB, Gopalka SK: Renal artery antihypertensive treatment. Br Med J 285: 1617, 1982.

    Article  CAS  Google Scholar 

  65. Michel JB, Dussaule JC, Choudat L, Auzan Corvol P, Menard J: Effects of antihypertensive treatment in one-clip, two kidney hypertension in rats. 1020, 1986.

    Google Scholar 

  66. Tykarski A, Edwards R, Dominiczak AF, Reid JL: Percutaneous transluminal renal angioplasty in the management of hypertension and renal failure in patients with renal artery J Hum Hypertens 7:491-496, 1993. rotic

    Google Scholar 

  67. Martinez-Amenos A, Rama H, Sarrias X, J, Montanya X: Percutaneous transluminal angioplasty in the treatment of renovascular hypertension. J Hum Hypertens 5: 97–100, 1991.

    PubMed  CAS  Google Scholar 

  68. Canzanello VJ, Millan VG, Spiegel JE, Ponce SP, Kopelman RI, Madias NE: Percutaneous transluminal renal angioplasty in management of atherosclerotic renovascular hypertension:results in 100 patients. Hypertension 13: 163–172, 1989.

    Article  PubMed  CAS  Google Scholar 

  69. Hansen KJ, Starr SM, Sands RE, Burkart JM, Plonk GW, Dean RH: Contemporary management of renovascular disease. J Vasc Surg 16: 319–331, 1992.

    Article  PubMed  CAS  Google Scholar 

  70. Novick AC, Ziegelbaum M, Vidt DG, Gifford RW, Pohl MA, Pickering TG, Sos TA, Saddekni S, Rozenblit G, James GD, Orenstein A, Helseth G, Laragh JH: Renal angioplasty in patients with azotemia and renovascular hypertension. J Hypertens 4: (Suppl): S667 — S669, 1986.

    Google Scholar 

  71. Dean RH, Englund R, Dupont WD, Meacham PW, Plummer WD, Pierce R, Ezell C: Retrieval of renal function by revascularization. Ann Surg 202: 367–375, 1985.

    Article  PubMed  CAS  Google Scholar 

  72. McCready RA, Daugherty ME, Nightbert EJ, Hyde GL, Freed man AM, Ernst CB: Renal revascularization in patients with a single functioning ischemic kidney. J Vasc Surg 6:185-1901987.

    Google Scholar 

  73. Askari A, Novick AC, Stewart BH, Straffon RA: Surgica disease in the solitary kidney: re- sults in 43 cases. J Urol 127: 20–23, 1982.

    PubMed  CAS  Google Scholar 

  74. Flatmark A, Jervell J, Sodal G: Surgical correction of hypertension in patients with one kidney. Scand J Urol Krneta A: Lasting Nephrol 14:81-83, 1980.

    Google Scholar 

  75. Madias NE, Kwon OJ, Millan VG: Percutaneous transluminal renal angioplasty. A potentially effective treatment for preser vation of renal function. Arch Intern Med 142: 693–697, 1982.

    Article  PubMed  CAS  Google Scholar 

  76. Weinberger MH, Grim CE, Luft FC, Yune HY: Percutaneous transluminal angioplasty in complicated renal vascular hyper tension. Nephron 44 (Suppl 1): 51–53, 1986.

    Article  PubMed  Google Scholar 

  77. Weinberger MH, Grim CE, Luft FC, Yune HY: Percutaneous with poorly controlled hypertension and renal insufficiency: a revascularization for recurrent pulmonary edema in patients distinct subgroup of patients with atherosclerotic renal artery occlusive disease. J Vasc Surg 15: 73–82, 1992.

    Google Scholar 

  78. Madias NE, Ball JT, Millan VG: Percutaneous transluminal hypertension. Am J Med 70: 1078–1084, 1981.

    Article  PubMed  CAS  Google Scholar 

  79. Mimran A: Renin-secreting tumors. In: JD Swales, Textbook of Hypertension. Blackwell Scientific Publications, Oxford, pp 858–864, 1993.

    Google Scholar 

  80. Dean RH, Tribble RW, Hansen KJ, O’Neil E, Craven TE, Redding JF: Evolution of renal insufficiency in ischemic renovas nephropathy. Ann Surg 213:446-456, 1991. cular

    Google Scholar 

  81. Mahler F, Probst P, Haertel M, Weidman P, improvement of renovascular hypertension by transluminal dilatation of atherosclerotic and nonatherosclerotic renal artery stenoses. Circulation 65: 611–6617, 1982.

    Article  PubMed  CAS  Google Scholar 

  82. Flechner S, Novick AC, Vidt D, Buonocore E, Meaney T: The use of percutaneous transluminal angioplasty of renal artery stenosis in patients with generalized atherosclerosis. J Urol 127: 1072–1075, 1982.

    PubMed  CAS  Google Scholar 

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Wadi N. Suki M.D. Shaul G. Massry M.D.

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Mourad, G., Halimi, JM., Ribstein, J., Mimran, A. (1998). Renal and Renovascular Hypertension. In: Suki, W.N., Massry, S.G. (eds) Suki and Massry’s THERAPY OF RENAL DISEASES AND RELATED DISORDERS. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-6632-5_70

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