Abstract
Five of 11 patients with hypertension secondary to surgically confirmed segmental ischemia had less than a 2:1 difference in urine flow rates between the two kidneys; significant lesions were present with as little as 11% increase in inulin concentrations. In addition, branch arterial stenosis may be so severe that no glomerular filtrate is produced by the ischemic segment of the kidney. In these cases the disparity in renal mass vs water may be the only abnormality seen on split function study. These findings suggest that some patients may have curable hypertension secondary to segmental artery disease involving such a small area of the kidney that strict adherence to previous criteria for a positive function study may be misleading.
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