Relief from malignant hypertension by treatment with captopril in a patient on maintenance hemodialysis.

A patient with end-stage renal disease due to malignant hypertension is described. Hypertension was resistant to hemodialysis. The orally active inhibitor of angiotensin-converting enzyme captopril (SQ 14.255; 2-D-methyl-3-mercaptopropanoyl-L-protein) dramatically lowered the elevated blood pressure both under ambulatory and dialysis conditions. No side effects were observed after 6 months' treatment. The effect of captopril could be described as a "biochemical nephrectomy".