Since the introduction of percutaneous transluminal renal angioplasty, it has become established as an effective treatment for the correction of
renovascular hypertension or the preservation of renal function. However, there has been a general reluctance to use it or other interventional procedures in any patient with a
solitary functioning kidney. We attempted renal angioplasty in 11 patients each of whom had a
solitary functioning kidney. All 11 had had either a previous contralateral
nephrectomy or an autonephrectomy from chronic
arterial occlusion. The patients ranged in age from 42 to 81 years. In nine of the 11 patients, a
catheter was negotiated across the
stenosis, and the lesion was dilated successfully. In two, the lesion could not be crossed. In the group of nine patients whose lesions were dilated successfully, clinical follow-up (2-180 weeks) revealed that
hypertension was cured in four and improved in five. Of the two patients in whom angioplasty was not possible, one required emergency renal bypass surgery and the other had no change in renal status. Renal function test results after the procedure were variable and did not correlate with decreases in blood pressure. We conclude that percutaneous renal angioplasty is a satisfactory alternative to surgery for the treatment of
renovascular hypertension or the preservation of renal function in a patient with a
solitary functioning kidney.