Abstract

We report the experience of a aregional centre serving a population of 3 millions in the management of patients with hypertyansion and unilateral scarred kidneys between 1972 and 1981. Thirty one patients with hypertension and unilateral scarred kidneys between 1972 and 1981. Thiry one patients were studied, fifteen havfe been subjected to nephrectomy and sixteen managed conservatively.

The medically and surgically treated patients differed only in that the diseased kidney was smaller, 7.7±1.9 vs 9.9±1.7 cm, (p<0.01), and systolic blood pressure higher, 224±34 vs 198±30 mm Hg, (p=0.05), in the surgically treated group.

Following hephrectomy blood present pressure was normal without drugs in four patients, control was made easier in only five. Serum creatinine did not increase folowing nephrectomy, but had increased significantly at the time of the most recent follow up in the medically treated patients (89 ± 20 to 102 ± 32 μmol 1−1, p < 0.05 ).

We conclude that nephrectomy is of value in the management of some patients with unilateral chronic pyelonephritis and need not results in loss of renal function. Renal vein renin studies may be helpful in selecting patients for surgery but examination of the effect of nephrectomy in patients without differences in renal vein is necessary to establish this.

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