Arterial hypertension is one of the most common disorders of man, and its incidence appears to be increasing as average life span becomes longer. Renovascular hypertension resulting from narrowing of one or both renal arteries is one of the surgically curable forms of this disorder. Application of revascularization techniques that both conserve the kidney and cure hypertension has provided intense interest in the surgical treatment of renovascular hypertension and has demonstrated a far higher incidence of this condition than was previously recognized.
Currently there is no simple and completely reliable screening study for renovascular hypertension, and final evaluation must be based on arteriographic demonstration of the renal arteries. Physiologic alterations associated with renal artery stenosis may point the way to a renovascular etiology in the hypertensive patient. For example, 30% of patients have abnormal excretory pyelograms with discrepancy in renal size or delayed contrast excretion, 60% have depression in the