一側水腎症によるレニン依存性高血圧症の1例

概要

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Acase of renin-dependent hypertension associated with unilateral hydronephrosis due to ureteropelvic junction stricture is reported. A 39 year old woman was admitted to our hospital for an evaluation of hypertension that was resistant to multiple antihyper-tensive agents. Hypertension was found at a health examination. She visited to a general practitioner and several antihypertensive agents were administered, however, her blood pressure did not respond to these medications and she was referred to us. On admission, her blood pressure was 210/140 mmHg, left enlarged kidney was palpated on physical examination. Mild renal dysfunction and increased plasma renin activity were noted on laboratory examination. Marked left hydronephrosis was found on ultrasound examination and computed tomography. There was no significant renal artery stenosis on renal arteriogram, but plasma renin activity in left renal vein was 2.8 times higher than that of right renal vein. Simple left nephrectomy was performed, and her blood pressure became normal and plasma renin activity was normal 10 days after operation. Hypertension associated with unilateral hydronephrosis was rare, only 9 cases were reported in the literatures in recent 15 years in Japan.
一般社団法人国立医療学会の論文