Renal artery stenosis of the transplanted kidney. Diagnosis and therapy of the hypertension.
Indications for the angiography, probability, of the diagnosis of renovascular hypertension and results of the surgical and medical treatment were considered in 16 patients with renal artery stenosis of the transplanted kidney. The evaluation shows that an increase in the blood pressure in patients with good, stabilized graft function is the most essential clinical symptom of the stenosis. An increase in the peripheral plasma renin activity is of diagnostic value only in the acute phase of the hypertension. The examination of the plasma renin activity in renal veins is valuable when deciding the indication for surgical therapy of hypertension. The results of surgical interventions in two patients with renal artery stenosis in the anastomosis supported the diagnosis of the renovascular hypertension and indicated that reason of the increased blood pressure and deterioration of the graft function need not be the same. In the course of the medical therapy 14 patients were followed--out of them ten patients for 1 to 4 years. The results showed the medical therapy had a good prognosis in these risk patients. Thus, the reconstruction of the artery is indicated only in the case of serious stenosis threatening the loss of graft function and in the case of the accelerated hypertension.