Hypertension due to Renal Artery Stenosis Caused by Abdominal Aortic Aneurysm

IT 1S now more than a quarter of a century since Goldblatt et al.1 reported that partial occlusion of one renal artery could produce a sustained rise in blood pressure. Wilson and Byrom2 extended this work, and showed that this increase in blood pressure could sometimes be reversed by removal of the clamped kidney. Since that time there have been many reports of the cure of hypertension by nephrectomy when renal disease has been shown to be unilateral. Most of these successes, however, have been in patients with unilateral renal disease due to pyelonephritis, and much less commonly in patients with local obstruction of a renal artery. More recently, aortography has been widely employed to define stenotic lesions of the renal arteries, and since this technic has been introduced it has been shown that such lesions of the renal vessels are more common than was previously supposed.' De Camp and Birchall,4 reviewed the causes of renal artery stenosis, and found only one case that was associated with aneurysm of the abdominal aorta.5 Brown et al. added two further cases. We report here a patient in whom this rare association occurred, and whose high blood pressure was successfully treated by removal of the affected kidney.