Failure of patent aorto-renal grafts to cure hypertension in renin positive patients.

Correction of renal artery stenosis in a hypertensive patient does not always result in cure of the hypertension. In a follow-up on 127 patients operated on for renovascular hypertension over a 24-year period 32 patients with favourable preoperative factors, unilateral disease, normal renal parenchyma and a positive renal vein renin ratio were studied. 20/32 were regarded as cured with a BP of less than 140/90 and 12/32 were regarded as unsuccessful with a BP, although lessened, higher than 140/90. Hypotensive medication was required in 10/12 in the latter group and was still required in 8/20 of the former. The cure rate of less than 2/3rd is lower than most reports in the literature. The possible causes of the discrepancy are discussed.