Long-term minoxidil therapy in patients with refractory hypertension and renal disease.

Minoxidil, an orally effective vasodilator, was successful in lowering blood pressure in 22 patients, followed up for up to 3 yrs, with hypertension refractory to medical management, including both antihypertensive drug combinations and ultrafiltration. In nondialysis patients renal function was preserved and in dialysis patients bilateral nephrectomy was avoided. Although sodium retention and reflex tachycardia were common, they were managed by beta-adrenergic blockade with propranolol and diuresis with furosemide.