Renal artery stenosis with severe hypertension. A rare case with detailed assessment of renin-angiotensin system before and after development of lesion.

The rare opportunity arose to assess in detail the renin-angiotensin system before and after the development of a renal artery stenosis with severe hypertension. Peripheral plasma concentrations of renin, angiotensin II, and aldosterone were known to be normal before the development of renal artery stenosis, and there were no lateralising features on renal vein sampling. Acute hypertension associated with very high peripheral plasma concentrations of renin and angiotensin II, and with pronounced lateralisation on renal vein sampling followed the development of acute unilateral renal artery stenosis. These measurements all returned to normal after nephrectomy, conforming with the pattern of changes previously established only in experimental animals.