Clinical Aspects Of Renovascular Hypertension

Diagnostic and therapeutic methods and controversies in the management of renovascular hypertension have undergone major ch- ges during the past few years. This book is based on the proceedings of a successful postgraduate Boerhaave Course held in 1982 at the Faculty of Medicine of the University of Leiden, The Netherlands. Current concepts concerning the diagnosis and treatment of reno vascular hypertension were presented during this course to an audience composed of physicians, nephrologists, cardiologists, surgeons, uro logists, and radiologists. Thus, this book aims at offering an overview of tho,se aspects of renovascular hypertension which are relevant to clinical pr- tice. An effort is made to review the currently available moda lities of diagnostic procedures, both on the basis of modern in sights in the pathology and pathophysiology of renovascular hyper tension, as well as timely r'esul ts of clinical research. In ad dition, several chapters deal with combinations of these di- nostic procedures in a fashion that can be of practical help in clin;cal decision making. The medical, surgical and angioplastic modalities of treatment are reviewed. Basic considerations concerning medical treatment and technical aspects of surgical as well as per cutaneous angioplasty are presented in detail, both separately and in combination. Special attention is given to the problem of renal artery stenosjs in k~dney transplants. This book offers up to date information on clinical aspects of renovascular hypertension, useful to a wide range of clinicians in a variety of disciplines.

During the last few years, renal hypertension has become a subject of increasing importance. The development of improved radiological techniques, notably intravenous and intra-arterial digital subtraction angiography, has made the diagnosis of renal artery stenosis more reliable, while advances in vascular surgery and the introduction of percutaneous trans luminal angioplasty have caused major changes in clinical practice. The increasing use of such potent antihypertensive agents as the angiotensin I converting enzyme inhibitors has empha sized the problem of renal artery stenosis in older patients with wide spread vascular disease as well as improving the prognosis of patients with accelerated hypertension. This book examines the surgical and medical aspects of renal hyper tension in the light of these recent advances. Each chapter has been written by a recognized expert in the field and provides information of relevance and practical importance to the average clinician. The developments of the last decade have emphasized that renal hyper tension is no longer a matter only for the nephrologist but a subject on which all clinicians should be well informed.

This is a reference text covering all aspects of renal disease, including: pathology, clinical features, imaging, hypertension, atherosclerotic disease, medical and surgical treatment.