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Renal Function During Long-Term Treatment of Hypertension with Minoxidil: Comparison of Benign and Malignant Hypertension

HELEN C. MITCHELL, M.D.; ROBERT M. GRAHAM, M.D.; and WILLIAM A. PETTINGER, M.D.
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Grant support: in part by grant 1-R01-HL23670-01 from the National Heart, Lung, and Blood Institute. Dr. Graham is a Pharmaceutical Manufacturer's Association Foundation Career Development Awardee in Clinical Pharmacology. Dr. Pettinger is a Burroughs-Wellcome Scholar.

▸Requests for reprints should be addressed to Helen C. Mitchell, M.D.; Department of Pharmacology, The University of Texas Health Science Center, 5323 Harry Hines Boulevard; Dallas, TX 75235.


Dallas, Texas


© 1980 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1980;93(5):676-681. doi:10.7326/0003-4819-93-5-676
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We examined the effect of long-term blood pressure control on renal function in 41 patients with refractory hypertension by using minoxidil, sympathetic suppressants, and diuretics continuously for 6 months to 7½ years. In 15 of 32 patients with benign hypertension, the serum creatinine concentration increased by more than 1 mg/dL, with nine of 15 requiring hemodialysis. Analysis of 1/serum creatinine versus time plots indicated that use of minoxidil delayed the onset of end-stage renal failure in some patients for up to 6 years. In the remaining 17 patients with benign hypertension, renal function remained stable with no decreases greater than 2 mg/dL. Four of nine patients presenting with malignant hypertension had marked and sustained improvement in renal function, although three initially required hemodialysis. The mean serum creatinine concentration in these four patients fell from 9.7 to 2.9 mg/dL. Thus, impressive renal functional improvement may occur with minoxidil use in some patients with malignant hypertension.

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