Surgical treatment of unilateral renal vascular disease: Prognostic role of vascular changes in bilateral renal biopsies

Abstract

In patients with unilateral renal arterial stenosis no distinction could be made between atherosclerotic or fibrous lesions of the main renal artery on the basis of the presence or severity of intrarenal arteriolar sclerosis. The results of bilateral renal biopsies performed at the time of operation support the concept of the “protected kidney,” in which the prevalence and severity of arteriolar sclerosis is greater in the kidney contralateral to the renal arterial stenosis. The presence or absence of arteriolar sclerosis as determined from bilateral renal biopsies was not sufficiently accurate as a prognostic index to justify the hazards of this procedure for patients being considered for surgical treatment of occlusive renal artery disease.