This diagnosis is suggested by the finding of elevated plasma renin levels, especially after captopril administration. Renal arteriography is important in defining the anatomy of the occlusion, and differential renal vein renin levels may show high levels of renin coming from the ischemic kidney. In carefully screened cases, revascularization of the ischemic kidneys is highly successful in relieving hypertension. In anatomically suitable cases, revascularization can be performed by percutaneous balloon angioplasty, although most cases require surgery. For more detailed discussion of renovascular hypertension, see Ch.
Femoral pulses are absent.
Claudication can be relieved by surgically bypassing the occluded area of the aorta with an aortoiliac or aortofemoral graft. All rights reserved.