Hypertension Caused by Renal Artery Stenosis: Goldblatt Hypertension

Abstract

Renal artery stenosis in conjunction with contralateral nephrectomy rapidly and predictably creates a stable hypertension. The renin-angiotensin system is initially activated but renin levels soon return to normal. In many instances body fluids and cardiac output are initially increased but they also return to normal in time. The eventual hemodynamic picture is one of a persistent hypertension with vasoconstriction and normal blood flow. One explanation is that renal artery stenosis initially impairs renal excretion, but that the situation is redressed by fluid retention, increased flows, autoregulatory vasoconstriction, and reestablishment of normal renal perfusion pressure and excretory capability.