The role of nephrectomy of the atrophic kidney in bearers of renovascular hypertension.
OBJECTIVE
Evaluation of the beneficial effect of nephrectomy of the atrophic kidney on blood pressure (BP) and renal function.


METHODS
A retrospective study of 51 patients with renovascular hypertension (RVH), bearers of atrophic kidney due to severe stenosis or occlusion of the renal artery. Average age was 47.1 +/- 15 years, the median creatinine clearance was 54 mL/min, average systolic BP (SBP) 149.6 +/- 22.5 mm Hg, average diastolic BP (DBP) 90.8 +/- 17 mm Hg and the median number of hypotensors 3 (1 to 5) per patient per day. Blood pressure and serum creatinine were analyzed from 12 to 60 months after the nephrectomy.


RESULTS
There was a significant improvement in the average SBP in the periods from 12 to 36 months (p < or = 0.028) and for the average DBP from 12 to 48 months after the nephrectomy (p < or = 0.045), accompanied by a significant reduction in the use of hypotensors from 12 to 48 months (p < 0.05). One year after the nephrectomy, there was a 69% improvement in blood pressure and 63.8% improvement in renal function of patients.


CONCLUSIONS
The removal of atrophic kidney in patients with RVH is a safe procedure which presents benefits for the control of arterial hypertension and renal function in bearers of renovascular hypertension.
Thomaz
Myrian J
MJ
Department of Urology, University of Sao Paulo, Sao Paulo, Brazil. m.j.thomaz@uol.com.br
Lucon
Antonio M
AM
Praxedes
Jose N
JN
Bortolotto
Luis A
LA
Srougi
Miguel
M
D001284:Atrophy / Q000601:surgery; D001794:Blood Pressure / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006978:Hypertension, Renovascular / Q000503:physiopathology / Q000601:surgery*; D007668:Kidney / Q000098:blood supply / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D011184:Postoperative Period; D057234:Preoperative Period; D012077:Renal Artery / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome