Blood pressure and renal outcomes in patients with kidney infarction and hypertension

J Hypertens. 2006 Aug;24(8):1649-54. doi: 10.1097/01.hjh.0000239302.55754.1f.


Objective: To assess the causes and frequency of kidney infarction associated with hypertension, and the blood pressure and renal function outcomes.

Methods: We analyzed the records of patients with kidney infarction documented by angiography and referred to a hypertension unit.

Results: Spontaneous kidney infarction was documented in 55 of 18,287 patients and was associated with renal artery disease in 41 cases. Twenty-five patients had a longstanding history of hypertension at referral, and 30 patients presented with acute hypertension. Patients with acute hypertension were more likely to report a history of lumbar pain and to develop malignant hypertension than patients with longstanding hypertension; they also had higher plasma renin concentrations. Data for long-term follow-up after referral were available for 36 patients, including 15 patients who underwent surgery or renal artery angioplasty. From referral to most recent follow-up, the blood pressure decreased from 176/111 to 143/89 mmHg in patients with longstanding hypertension, and from 183/111 to 127/80 mmHg in those with acute hypertension (P = 0.007/0.041 for between-group differences). Three patients with acute hypertension had normal blood pressure without treatment at follow-up. Patients with long-term follow-up displayed no change in the glomerular filtration rate.

Conclusion: Kidney infarction is a rare cause of hypertension, usually associated with renal artery lesions. In cases of kidney infarction with acute hypertension, the blood pressure outcome is favorable following intervention and/or medication, and hypertension may resolve spontaneously.

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Angiotensin II Type 1 Receptor Blockers / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Antihypertensive Agents / therapeutic use
  • Biomarkers / blood
  • Blood Pressure* / drug effects
  • Female
  • Follow-Up Studies
  • France
  • Glomerular Filtration Rate / drug effects
  • Humans
  • Hypertension, Renovascular / etiology
  • Hypertension, Renovascular / physiopathology*
  • Hypertension, Renovascular / therapy
  • Infarction / etiology
  • Infarction / physiopathology*
  • Infarction / therapy
  • Kidney / blood supply*
  • Kidney / physiopathology*
  • Male
  • Middle Aged
  • Renal Artery Obstruction / complications
  • Renal Artery Obstruction / physiopathology
  • Renal Artery Obstruction / therapy
  • Renin / blood
  • Treatment Outcome
  • Urologic Surgical Procedures


  • Angiotensin II Type 1 Receptor Blockers
  • Angiotensin-Converting Enzyme Inhibitors
  • Antihypertensive Agents
  • Biomarkers
  • Renin