[Show abstract][Hide abstract] ABSTRACT: In the past bilateral nephrectomy was often necessary in treating hypertensive scleroderma renal crisis. Since the availability of convertin enzyme inhibitors, many patients who were dialysis-dependent have recovered sufficiently to discontinue dialysis. We describe a 32-year-old woman with scleroderma who developed malignant hypertension and acute renal failure and required dialysis. She was treated aggressively with captopril and other agents. After 15 months, renal function improved and hemodialysis could be discontinued.