Nephrogenic Hypertension (Goldblatt Kidney) Following Operative Trauma to the Renal Artery

Abstract

The thrombosis of the right renal artery following operative injury set off a chain of events closely duplicating the arterial hypertension observed by Goldblatt after constriction or occlusion of the renal arteries in experimental animals. The resulting hypertension was severe, fulminating, prolonged, and resistant to treatment by hypotensive and ganglion-blocking agents; it was associated with pulmonary edema, myocardial infarction, and impairment of the renal function. Nephrectomy brought about a return of the blood pressure to normal levels. The concentration of renin in the removed kidney was 34 times greater than normal.

Malignant Hypertension Following Renal Artery Branch Obstruction

“…In man, the involvement of renin in the hypertension following partial re¬ nal infarction was indicated by Mc¬ Donald et al 6 They described a pa¬ tient with right renal artery throm¬ bosis and multiple infarcts in the right kidney who had severe hyper¬ tension that was corrected by nephrectomy. The renin content of the removed kidney (average of all tis¬ sue) was reported as being 34 times higher than the normal value for hu¬ man kidney renin.…”

An Unusual Case of Resistant Hypertension Secondary to Fibromuscular Dysplasia

“…McDonald et al. ( 5 ) described a patient with resistant hypertension who had right renal artery thrombosis resulting in multiple renal infarcts. The patient underwent a total nephrectomy that subsequently cured his BP.…”

Images in vascular medicine

“…1 A direct human template for the Goldblatt kidney model, however, is a rather rare occurrence. 2 A 71-year-old man with progressive chronic renal insufciency was referred to our institution for severe hypertension unresponsive to a ve drug anti-hypertensive regimen. He had a prior history of chronic hypertension, which had been well controlled on a single anti-hypertensive medication, until he underwent aorto-bifemoral bypass surgery at another institution for distal aortic occlusion and severe bilateral lower extremity claudication.…”