Reversal of "one kidney" to "two kidney" tipe of Goldblatt hypertension in a patient with bilateral artery stenosis.

A 32-year old hypertensive woman with bilateral renal artery stenosis of more than 50% on both sides was studied. Renal vein renin levels were low (0.3 ng/ml/h on the right side and 0.42 on the left) before surgical correction of the left renal artery. Thereafter, blood pressure was only temporarily reduced. Four months later a repeat angiography demonstrated a widely patent left renal artery and the stenosis on the right side was unchanged. Renal vein renin was 5.12 on the left and 11.2 on the right. Subsequent operation on the right side lead to normalization of blood pressure. Thus, our patient seems to demonstrate in sequence the characteristics of the tow types of experimental renovacular hypertension known as "one kidney hypertension" and "two kidney hypertension". Our findings usggest that the pathomechanisms of these experimental models are operative in man too.