Varying course of hypertension following renal trauma.

Hypertension developed in 5 patients after unilateral renal injury. The time-lag from injury to development of hypertension varied from 6 weeks to more than 3 years. In 2 of 3 patients with partial renal injury blood pressure normalized spontaneously. In the third patient sustained hypertension was cured by nephrectomy 56 months after injury. Nephrectomy led to normotension in the 2 patients with renal artery thrombosis, in 1 of them 14 years after renal trauma. Activation of the renin aldosterone axis was observed in all patients. The causes of varying time-lag from renal injury to onset of hypertension are obscure. Because of possible spontaneous regression of hypertension sufficient followup is recommended in patients with a history of renal injury. On the other hand, nephrectomy may be curative even after long-standing hypertension caused by traumatic renal artery thrombosis.