Renal artery stenosis does not necessarily cause hypertension in man.1,2 Even stenosis of over 50% of the luminal diameter has been found in normotensive patients. On the other hand total renal arterial occlusion is associated with renal ischemia and is considered capable of producing renovascular hypertension. We have recently examined a patient who suddenly became hypertensive in 1966 and in whom a nonfunctioning left kidney was shown by urography. A subsequent arteriogram demonstrated a complete left renal artery occlusion. One and one half years later sufficient collateral circulation had developed to permit good function in the diseased kidney and a normal intravenous pyelogram. The hypertension improved markedly, and renal vein renin activity was normal.
A 47-year-old black housewife was referred to the Peter Bent Brigham Hospital in 1968 for evaluation of hypertension of 1½ years' duration. She gave a history of recurrent edema of the face,