[Reno-vascular hypertension surgery and renal: systemic renin index (author's transl)].

Thirty-two consecutive hypertensive patients with renal artery stenoses have been operated on. Surgical procedures were aorta-renal artery grafting, renal artery endarteriectomies and resection-anastomosis. Results were analysed with respect to the radiologic type of the stenosis (i.e. arteriosclerosis (AS) or fibromuscular dysplasia (FMD) and to the value of Renal: Systemic Renin Indices (RSRI) available in 30 cases. Out of 15 FMD cases, 14 are completely cured while in 5/15 cases RSRI values were not significant. 1/15 case is a failure, RSRI was here not significant. Out of 16 AS cases, 2 died in the immediate postoperative period. Out of 14 AS survivors, 11 are completely normotensive, 2 are only improved (in 11/13 cases where RSRI were available, they were significant) and 1 is a failure (in that case RSRI was not significant). One case of arteriovenous fistula is reported; reliable RSRI determination can not be obtained in that pathology. It is the author's suggestion that every case of FMD related renovascular hypertension should be operated on irrespectively of RSRI value. Opposingly, in AS case, operative decision is dependent on prior determination of RSRI.