Nitroprusside can lower GFR in bilateral renal artery stenosis

Effect on the glomerular filtration rate (GFR) of lowering the systemic blood pressure with increasing doses of nitroprusside in patients with unilateral (squares) and severe bilateral (circles) renal artery stenosis. The GFR remained relatively stable with unilateral disease but fell substantially with bilateral involvement. In the latter setting, renal perfusion pressure distal to the stenotic lesions presumably fell below the autoregulatory range despite the lack of interference with angiotensin II.