Hypertension and unilateral renal disease treated by nephrectomy.

At the present time most patients with hypertension can only be offered mitigation of their disease and alleviation of their symptoms. Cure is possible only in certain well-defined syndromes such as phaeochromocytoma, primary hyperaldosteronism, coarctation of the aorta, and unilateral renal disease. The work relating to this last cause of hypertension has recently been reviewed by Smith (1956) who analysed 575 cases, reported from 1937 to 1956, in which nephrectomy was carried out for proven or suspected unilateral renal disease with associated hypertension. Of these 575 cases, 149 were "cured" by nephrectomy, in that their blood pressure fell to 140/90 or less for a period of at least a year after operation. The commonest lesion found at nephrectomy was pyelonephritis and, less commonly, hydronephrosis, atrophic kidney, and arterial occlusion. In this paper we describe the effect of nephrectomy in three further cases.