Recurrent pulmonary oedema in hypertension due to bilateral renal artery stenosis: treatment by angioplasty or surgical revascularisation.
11 patients with atheromatous renovascular hypertension had a history of multiple episodes of pulmonary oedema. 7 had stenosis of both renal arteries, 2 had stenosis of the artery to a solitary kidney, and 2 had unilateral stenosis with an intact contralateral kidney. Successful revascularisation (by angioplasty in 8, and surgery in 3) improved blood pressure and renal function, and virtually eliminated pulmonary oedema. In a second series of 55 consecutive patients with azotaemia and renovascular hypertension, pulmonary oedema occurred in 13 (23%). Blood pressure and renal function were not significant predictors of pulmonary oedema, but coronary heart disease and bilateral (vs unilateral) renal artery stenosis were. Bilateral renal artery stenosis may be a specific and treatable predisposing factor to pulmonary oedema in azotaemic hypertensive patients.
D000208:Acute Disease; D000368:Aged; D000800:Angioplasty, Balloon; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications; D006801:Humans; D006978:Hypertension, Renovascular / Q000150:complications / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011654:Pulmonary Edema / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D012008:Recurrence; D012078:Renal Artery Obstruction / Q000601:surgery / Q000628:therapy*; D012501:Saphenous Vein