Hypertension and nephrology

[Thought about renovascular hypertension by a special case report]

GAJDÁN Nikolett1, LÉGRÁDY Péter1, BAJCSI Dóra1, MORVAY Zita2, NAGY Endre2, LETOHA Annamária2, KYPROS Constantinou1, FEJES Imola1, SONKODI Sándor1, ÁBRAHÁM György1

SEPTEMBER 10, 2017

Hypertension and nephrology - 2017;21(04)

[Renovascular hypertension is a well-known form of secunder hypertension. Two thirds of cases are caused by atherosclerotic plaque and one third are caused by fibromuscular dysplasia. The prevalence of it is less than 1%. Digital subtraction angiography is considered the goldstandard diagnostic method. The 58-year old female patient was hospitalized with resistant hypertension. Duplex ultrasonography showed fibromuscular stenosis the in left renal artery. Percutaneous transluminal angioplasty and stenting were performed. Her blood pressure normalized. The patient did not attend the control examinations. Next time in 2001, she was referred to our emergency department with increased blood pressure of 210/140 mmHg. Following control ultrasonography angiography showed total occlusion of the left renal artery and significant stenosis of the right renal artery. Left nephrectomy was necessary due to shrunken kidney and dilatation and stenting of the right renal artery. The blood pressure normalized again. Since 2004 until 2014 despite of the regular visits, we detected in stent restenosis of the right renal artery almost in each year. Even so, renal function was preserved all the time. In autumn of 2014, the patient suffered severe stroke, and few months later at the age of 74 she died. There are many open questions to discus concerning the right treatment of renovascular hypertension yet. Even so by performing 12 intravascular interventions we could ensure her acceptable quality of life for 16 years.]

AFFILIATIONS

  1. Szegedi Tudományegyetem, ÁOK, I. Sz. Belgyógyászati Klinika, Nephrologia-Hypertonia Centrum, Szeged
  2. Szegedi Tudományegyetem, ÁOK, Radiológiai Klinika, Szeged

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