AUTOTRANSPLANTATION OF A CONGENITAL SOLITARY KIDNEY FOR RENOVASCULAR HYPERTENSION

A 42-year-old male with renovascular hypertension involving left congenital solitary kidney is reported. The pathophysiology of this case closely resembled that of experimental one. kidney Goldblatt hypertension in the following respects: peripheral renin activity was normal without the treatment to reduce the plasma volume, but it increased and the blood pressure was lowered in response to angiotensin II analogue by means of sodium restriction and administration of furosemide. Renin activity was increased when angiotensin I converting enzyme inhibitor was administered. When renal autotransplantation was performed as a renal revascularization procedure, the blood pressure became normal. It is necessary to correct plasma volume if renin dependence of renovascular hypertension cases involving patient with a solitary kidney is to be proved. Among the available renal artery reconstruction procedures, renal autotransplantation is the method of choice because it provides wide exposure with minimal risk of technical failure or postoperative vascular complications.