Retrieval of renal function by revascularization of renovascular disease.

Renal dysfunction due to renal artery occlusive disease is potentially reversible and this diagnosis should be considered in all patients with renal failure, especially in patients with other manifestations of occlusive peripheral vascular disease, those with severe hypertension, and those over 45 or under 20 years of age at the onset of hypertension (i.e., older or younger than the usual age for onset of "essential" hypertension). Renovascular disease should also be suspected in hypertensive patients with mild to modest impairment of renal function who demonstrate a sudden worsening of renal function following administration of an angiotensin-converting enzyme inhibitor. Effective and safe techniques for renal revascularization are available in almost all cases to achieve greater longevity and improved quality of life, as well as to reduce the economic impact of chronic renal failure and renovascular hypertension.