Autotransplantation of the kidney for fibromuscular dysplasia of the renal arteries.

A young man was discovered to have symptomless hypertension, which subsequently proved to be caused by fibromuscular dysplasia of the renal arteries. Arterial disease was present on both sides but was more severe on the right. Samples of blood were obtained by selective catheterisation of each renal vein for the determination of plasma renin activity. The renal venous renin was greater on the right than on the left (ratio greater than 1-5 to 1) and secretion of renin by the left kidney was suppressed. Autotransplantation of the right kidney to the left internal iliac artery lowered the blood pressure at once and it has remained normal for 6 months. The implications of this procedure for the management of a bilateral disorder of the renal arteries, such as fibromuscular dysplasia, are discussed.