Renal Function During Long-Term Treatment of Hypertension with Minoxidil

In a study conducted 42 years ago, the impact of long-term blood pressure control on renal function was examined in 41 patients with refractory hypertension using minoxidil, sympathetic suppressants, and diuretics for a period of 6 months to 7.5 years. The serum creatinine concentration increased by more than 1 mg/dL in 15 out of 32 patients with benign hypertension, with nine of these 15 requiring hemodialysis. However, the use of minoxidil appeared to delay 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 out of nine patients with malignant hypertension showed marked and sustained improvement in renal function, with the mean serum creatinine concentration falling from 9.7 to 2.9 mg/dL, suggesting that minoxidil use may lead to significant renal functional improvement in some patients with malignant hypertension.