Hypertension in radiation nephritis. Report of a patient with unilateral disease, elevated renin activity levels, and reversal after unilateral nephrectomy.

A patient received intensive radiation to the right renal area for abdominal Hodgkin's disease and approximately ten years later severe hypertension developed. The presence of radiation nephritis with a severely shrunken right kidney was demonstrated and this was accompanied by a substantial increase in renin activity from the right kidney. Treatment with propranolol hydrochloride temporarily lowered the blood pressure and peripheral renin activity levels. Subsequent right nephrectomy resulted in a decrease in renin activity and a reversal of the hypertension. The data implicate a renin angiotensin mechanism as probable cause of hypertension in radiation nephritis.