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Malignant Renal Hypertension: Twenty-Year Medical History

Malignant Renal Hypertension: Twenty-Year Medical History Abstract Experimental research revealed the relationship of renal disease to hypertension1 and led clinicians to investigate cases of hypertension for unilateral renal lesions with the hope of restoring the blood pressure to normal by removal of the diseased kidney. Proof of cure requires long follow-up study because hypertension may temporarily recede after any surgery, only to become manifest at a later date. This case report is a 20-year medical history of severe malignant hypertension associated with hypertensive retinopathy and encephalopathy relieved by nephrectomy. Report of a Case At the age of 19 years, a white woman delivered a normal baby on March 24, 1939, after a normal pregnancy. The blood pressure at that time was 110 mm. Hg. systolic, and 70 mm. diastolic. Six weeks later she developed severe persistent headaches, tinnitus, visual difficulty, and a reported systolic blood pressure of "196." On May 11, 1939, after a severe headache, References 1. Goldblatt, H.; Lynch, J.; Hanzal, R. F., and Summerville, W. W.: Studies on Experimental Hypertension: Production of Persistent Elevation of Systolic Blood Pressure by Means of Renal Ischemia , J. Exper. Med. 59:347-379 ( (March) ) 1934.Crossref 2. Braasch, W. F.; Walters, W., and Hammer, H. J.: Hypertension and the Surgical Kidney , J.A.M.A. 115:1837 ( (Nov. 30) ) 1940.Crossref 3. Baggenstoss, A. H., and Barker, N. W.: Unilateral Renal Atrophy Associated with Hypertension , Proc. Mayo Clin. 16:8-33 ( (Dec. 31) ) 1941. 4. Poutasse, E. F.: Occlusion of a Renal Artery as a Cause of Hypertension , Circulation 13:37-48 ( (Jan.) ) 1956.Crossref 5. Price, R. K., and Skelton, R.: Hypertension Due to Syphilitic Occlusion of Main Renal Arteries , Brit. Heart J. 10:29-33 ( (Jan.) ) 1948.Crossref 6. Teplick, J. G., and Yarrow, M. W.: Arterial Infarction of Kidney , Ann. Intern. Med. 42:1041-1051 ( (May) ) 1955.Crossref 7. Pastor, B. H.; Myerson, R. M.; Wohl, G. T., and Rouse, P. V.: Hypertension Associated with Renal Artery Aneurysm and Relieved by Nephrectomy , Ann. Intern. Med. 42:1122-1130 ( (May) ) 1955.Crossref 8. Case Records of the Massachusetts General Hospital, Cabot Case 41451, Clinical Diagnosis: Dissecting Aneurysm of Aorta , New Engl. J. Med. 253:824-828 ( (Nov. 10) ) 1955.Crossref 9. Imber, I., and Clyner, R. H., Jr.: Obstruction of the Renal Artery Producing Malignant Hypertension , New Engl. J. Med. 252:301 ( (Feb. 24) ) 1955.Crossref 10. Brandt, J. L., and Gruhn, J. G.: Effects of Renin on Proteinuria and PAH Clearance at Low Plasma Levels , Amer. J. Physiol. 153:458-464 ( (June) ) 1948. 11. Maitland, A. I. L.: Discussion on Unilateral Renal Hypertension , Proc. Roy. Soc. Med. 45: 731 ( (April 24) ) 1952. 12. Laforet, E. G.: Malignant Hypertension Associated with Unilateral Renal Artery Occlusion: 3 Cases , Ann. Intern. Med. 38:677-688 ( (April) ) 1953. 13. Perera, G. A., and Haelig, A. W.: Clinical Characteristics of Hypertension Associated with Unilateral Renal Disease , Circulation 6:549 ( (Oct.) ) 1952.Crossref 14. Braasch, W. F.: End Results Following Nephrectomy in Patients with Hypertension , J. Urol. 68:6 ( (July) ) 1952. 15. Poutasse, E. F.: Renal Artery Aneurysm: Report of 12 Cases, 2 Treated by Excision of the Aneurysm and Repair of Renal Artery , J. Urol. 77:697-708 ( (May) ) 1957. 16. Winter, C. C.: Unilateral Renal Disease and Hypertension: Use of the Radioactive Diodrast Renogram as a Screening Test , J. Urol. 78:107-116 ( (Aug.) ) 1957. 17. Leadbetter, W. F., and Burkland, C. E.: Hypertension in Unilateral Renal Disease , J. Urol. 39:611 ( (May) ) 1938. 18. Gilfillan, R. S.; Smart, W. R., and Bostick, W. L.: Dissecting Aneurysm of Renal Artery , A.M.A. Arch. Surg. 73:737-740 ( (Nov.) ) 1956.Crossref 19. Smith, D. R., in discussion on Arbuckle, J. W., Jr.: Urological Aspects of Hypertension , Transactions of The Western Section, American Urological Association, 36th Annual Meeting, 1960 , to be published. 20. Kattus, A. A., Jr.; Longmire, W. P.; Cannon, J. A.; Webb, R., and Johnston, C.: Primary Intraluminal Tumor of the Aorta Producing Malignant Hypertension , New Engl. J. Med. 262: 694 ( (April 7) ) 1960.Crossref 21. Scheiflez, C. H.: A New Clinical Syndrome Producing Hypertension—Arteriovenous Fistula of the Kidney , J.A.M.A. 174:1625-1627 ( (Nov. 19) ) 1960.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Malignant Renal Hypertension: Twenty-Year Medical History

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Publisher
American Medical Association
Copyright
Copyright © 1961 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1961.03620100080011
Publisher site
See Article on Publisher Site

Abstract

Abstract Experimental research revealed the relationship of renal disease to hypertension1 and led clinicians to investigate cases of hypertension for unilateral renal lesions with the hope of restoring the blood pressure to normal by removal of the diseased kidney. Proof of cure requires long follow-up study because hypertension may temporarily recede after any surgery, only to become manifest at a later date. This case report is a 20-year medical history of severe malignant hypertension associated with hypertensive retinopathy and encephalopathy relieved by nephrectomy. Report of a Case At the age of 19 years, a white woman delivered a normal baby on March 24, 1939, after a normal pregnancy. The blood pressure at that time was 110 mm. Hg. systolic, and 70 mm. diastolic. Six weeks later she developed severe persistent headaches, tinnitus, visual difficulty, and a reported systolic blood pressure of "196." On May 11, 1939, after a severe headache, References 1. Goldblatt, H.; Lynch, J.; Hanzal, R. F., and Summerville, W. W.: Studies on Experimental Hypertension: Production of Persistent Elevation of Systolic Blood Pressure by Means of Renal Ischemia , J. Exper. Med. 59:347-379 ( (March) ) 1934.Crossref 2. Braasch, W. F.; Walters, W., and Hammer, H. J.: Hypertension and the Surgical Kidney , J.A.M.A. 115:1837 ( (Nov. 30) ) 1940.Crossref 3. Baggenstoss, A. H., and Barker, N. W.: Unilateral Renal Atrophy Associated with Hypertension , Proc. Mayo Clin. 16:8-33 ( (Dec. 31) ) 1941. 4. Poutasse, E. F.: Occlusion of a Renal Artery as a Cause of Hypertension , Circulation 13:37-48 ( (Jan.) ) 1956.Crossref 5. Price, R. K., and Skelton, R.: Hypertension Due to Syphilitic Occlusion of Main Renal Arteries , Brit. Heart J. 10:29-33 ( (Jan.) ) 1948.Crossref 6. Teplick, J. G., and Yarrow, M. W.: Arterial Infarction of Kidney , Ann. Intern. Med. 42:1041-1051 ( (May) ) 1955.Crossref 7. Pastor, B. H.; Myerson, R. M.; Wohl, G. T., and Rouse, P. V.: Hypertension Associated with Renal Artery Aneurysm and Relieved by Nephrectomy , Ann. Intern. Med. 42:1122-1130 ( (May) ) 1955.Crossref 8. Case Records of the Massachusetts General Hospital, Cabot Case 41451, Clinical Diagnosis: Dissecting Aneurysm of Aorta , New Engl. J. Med. 253:824-828 ( (Nov. 10) ) 1955.Crossref 9. Imber, I., and Clyner, R. H., Jr.: Obstruction of the Renal Artery Producing Malignant Hypertension , New Engl. J. Med. 252:301 ( (Feb. 24) ) 1955.Crossref 10. Brandt, J. L., and Gruhn, J. G.: Effects of Renin on Proteinuria and PAH Clearance at Low Plasma Levels , Amer. J. Physiol. 153:458-464 ( (June) ) 1948. 11. Maitland, A. I. L.: Discussion on Unilateral Renal Hypertension , Proc. Roy. Soc. Med. 45: 731 ( (April 24) ) 1952. 12. Laforet, E. G.: Malignant Hypertension Associated with Unilateral Renal Artery Occlusion: 3 Cases , Ann. Intern. Med. 38:677-688 ( (April) ) 1953. 13. Perera, G. A., and Haelig, A. W.: Clinical Characteristics of Hypertension Associated with Unilateral Renal Disease , Circulation 6:549 ( (Oct.) ) 1952.Crossref 14. Braasch, W. F.: End Results Following Nephrectomy in Patients with Hypertension , J. Urol. 68:6 ( (July) ) 1952. 15. Poutasse, E. F.: Renal Artery Aneurysm: Report of 12 Cases, 2 Treated by Excision of the Aneurysm and Repair of Renal Artery , J. Urol. 77:697-708 ( (May) ) 1957. 16. Winter, C. C.: Unilateral Renal Disease and Hypertension: Use of the Radioactive Diodrast Renogram as a Screening Test , J. Urol. 78:107-116 ( (Aug.) ) 1957. 17. Leadbetter, W. F., and Burkland, C. E.: Hypertension in Unilateral Renal Disease , J. Urol. 39:611 ( (May) ) 1938. 18. Gilfillan, R. S.; Smart, W. R., and Bostick, W. L.: Dissecting Aneurysm of Renal Artery , A.M.A. Arch. Surg. 73:737-740 ( (Nov.) ) 1956.Crossref 19. Smith, D. R., in discussion on Arbuckle, J. W., Jr.: Urological Aspects of Hypertension , Transactions of The Western Section, American Urological Association, 36th Annual Meeting, 1960 , to be published. 20. Kattus, A. A., Jr.; Longmire, W. P.; Cannon, J. A.; Webb, R., and Johnston, C.: Primary Intraluminal Tumor of the Aorta Producing Malignant Hypertension , New Engl. J. Med. 262: 694 ( (April 7) ) 1960.Crossref 21. Scheiflez, C. H.: A New Clinical Syndrome Producing Hypertension—Arteriovenous Fistula of the Kidney , J.A.M.A. 174:1625-1627 ( (Nov. 19) ) 1960.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Oct 1, 1961

References