RECENTLY, it has been suggested that a vascular lesion that affects only a portion of one kidney may have etiologic importance.1 We report a case of hypertension in which regional renal renin elevation and a stenotic lesion of an artery supplying a segment of a solitary horseshoe kidney appeared to be responsible for the observed elevation of blood pressure. To the best of our knowledge, this constellation of clinical, radiologic, and laboratory findings has not been previously reported.
Report of a Case
A 63-year-old man had apparently been well until May 1974, when he experienced a ten-minute episode of dizziness and unsteadiness of gait. Results of neurological examination were normal, but his blood pressure was 220/130 mm Hg.Therapy with hydrochlorothiazide failed to reduce the hypertension satisfactorily. He was admitted to the San Diego Veterans Administration Hospital with a second episode of dizziness, diplopia, and intermittent ataxia. His blood