Recurrent pulmonary oedema in hypertension due to bilateral renal artery stenosis: treatment by angioplasty or surgical revascularisation

Lancet. 1988 Sep 3;2(8610):551-2. doi: 10.1016/s0140-6736(88)92668-2.


11 patients with atheromatous renovascular hypertension had a history of multiple episodes of pulmonary oedema. 7 had stenosis of both renal arteries, 2 had stenosis of the artery to a solitary kidney, and 2 had unilateral stenosis with an intact contralateral kidney. Successful revascularisation (by angioplasty in 8, and surgery in 3) improved blood pressure and renal function, and virtually eliminated pulmonary oedema. In a second series of 55 consecutive patients with azotaemia and renovascular hypertension, pulmonary oedema occurred in 13 (23%). Blood pressure and renal function were not significant predictors of pulmonary oedema, but coronary heart disease and bilateral (vs unilateral) renal artery stenosis were. Bilateral renal artery stenosis may be a specific and treatable predisposing factor to pulmonary oedema in azotaemic hypertensive patients.

MeSH terms

  • Acute Disease
  • Aged
  • Angioplasty, Balloon*
  • Female
  • Follow-Up Studies
  • Heart Failure / complications
  • Humans
  • Hypertension, Renovascular / complications
  • Hypertension, Renovascular / surgery
  • Hypertension, Renovascular / therapy*
  • Male
  • Middle Aged
  • Pulmonary Edema / etiology
  • Pulmonary Edema / surgery
  • Pulmonary Edema / therapy*
  • Recurrence
  • Renal Artery Obstruction / surgery
  • Renal Artery Obstruction / therapy*
  • Saphenous Vein