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Nakamura Y, Kobayashi H, Kanai K, Abe M. Sudden-onset hypertension leading to the diagnosis of unilateral hydronephrosis due to ureteropelvic junction obstruction. CEN Case Rep 2024; 13:243-248. [PMID: 38015311 PMCID: PMC11294294 DOI: 10.1007/s13730-023-00832-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 10/20/2023] [Indexed: 11/29/2023] Open
Abstract
We present a case of a 41-year-old female who developed hypertension over a three-month period and was subsequently diagnosed with ureteropelvic junction obstruction (UPJO). The patient came to our department with elevated blood pressure. Blood examinations revealed normal renal function, hypokalemia and increased renin-angiotensin system (RAS) activity, as indicated by elevated level of plasma renin activity and plasma aldosterone level. A computed tomography imaging further revealed dilation of the left renal pelvis, atrophy of the left kidney, and indications of obstruction at the junction between the renal pelvis and ureter. Surgical intervention in the form of a left pyeloplasty successfully resolved the unilateral hydronephrosis, corrected the elevated RAS activity, normalized the blood pressure, and ameliorated the hypokalemia. This case emphasizes that elevated blood pressure might be the sole clinical indication of hydronephrosis. It's crucial to consider hydronephrosis due to UPJO as a potential cause, especially when diagnosing hypertension associated with RAS hyperactivity in young adults. It also highlights the effectiveness of surgical intervention in treating hypertension in such scenarios.
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Affiliation(s)
- Yoshihiro Nakamura
- Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-Chou, Itabashi-Ku, Tokyo, 173-8610, Japan
| | - Hiroki Kobayashi
- Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-Chou, Itabashi-Ku, Tokyo, 173-8610, Japan.
| | - Kunimitsu Kanai
- Department of Urology, National Hospital Organization Saitama Hospital, Saitama, Japan
| | - Masanori Abe
- Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-Chou, Itabashi-Ku, Tokyo, 173-8610, Japan
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2
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Taniguchi T, Yamamoto K, Tomita M, Iehara N. Renal tamponade in a patient with hydronephrosis-related Page kidney. CEN Case Rep 2023; 12:378-383. [PMID: 36856751 PMCID: PMC10620360 DOI: 10.1007/s13730-023-00779-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 02/14/2023] [Indexed: 03/02/2023] Open
Abstract
A 48-year-old woman presented with hyperreninemic hypertension and renal dysfunction and was diagnosed with hydronephrosis-related Page kidney. The pathophysiology was "renal tamponade", in which the kidney was compressed by the renal pelvis and Gerota's fascia, resulting in intrarenal microvascular ischemia. Ureteral stent placement promptly improved the hyperreninemic hypertension and renal dysfunction, and additional perirenal fluid drainage gradually improved these conditions. These observations indicated the following three points. First, renal compression-induced renin-angiotensin-aldosterone system upregulation plays an important role in the pathogenesis of Page kidney. Second, physicians should consider perirenal fluid drainage as a therapeutic option in addition to ureteral stenting in patients with hydronephrosis-related Page kidney. Third, bilateral perirenal subcapsular hematomas in this case could be caused by hydronephrosis. Hydronephrosis-induced intrarenal pressure elevation possibly caused chronic perirenal subcapsular hemorrhage at the vulnerable sites of the renal cortex and peeling of the renal capsule from the cortex, resulting in the bilateral massive subcapsular hematomas and Page kidney.
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Affiliation(s)
- Tomoki Taniguchi
- Department of Nephrology, Kyoto City Hospital, 1-2 Mibu Higashitakadacho, Nakagyo-Ku, Kyoto-Shi, Kyoto-Fu, Kyoto, 604-8845, Japan.
| | - Kojiro Yamamoto
- Department of Nephrology, Kyoto City Hospital, 1-2 Mibu Higashitakadacho, Nakagyo-Ku, Kyoto-Shi, Kyoto-Fu, Kyoto, 604-8845, Japan
| | - Mayumi Tomita
- Department of Nephrology, Kyoto City Hospital, 1-2 Mibu Higashitakadacho, Nakagyo-Ku, Kyoto-Shi, Kyoto-Fu, Kyoto, 604-8845, Japan
| | - Noriyuki Iehara
- Department of Nephrology, Kyoto City Hospital, 1-2 Mibu Higashitakadacho, Nakagyo-Ku, Kyoto-Shi, Kyoto-Fu, Kyoto, 604-8845, Japan
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3
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Carlström M. Hydronephrosis and risk of later development of hypertension. Acta Paediatr 2019; 108:50-57. [PMID: 29959876 DOI: 10.1111/apa.14482] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 06/19/2018] [Accepted: 06/27/2018] [Indexed: 12/25/2022]
Abstract
AIM Congenital ureteral obstruction is a fairly common condition in infants, and its clinical management has been long debated during the last decade. The long-term physiological consequences of today's conservative non-surgical management in many asymptomatic hydronephrotic children are unclear. METHODS Experimental studies in rats and mice, retrospective studies in children and adults, as well as prospective studies in children are included in this mini review. RESULTS Experimental models of hydronephrosis in rats and mice have demonstrated that partial ureteropelvic junction obstruction (UPJO) is casually linked with development of hypertension and renal injuries in later life. The mechanisms are multifactorial and involve increased activity of the renin-angiotensin-aldosterone system and renal sympathetic nerve activity. Furthermore, oxidative stress and nitric oxide deficiency in the affected kidney appear to play important roles in the development and maintenance of hypertension. Clinical case reports in adults and recent prospective studies in children have associated hydronephrosis with elevated blood pressure, which could be reduced by surgical management of the obstruction. CONCLUSION Based on current experimental and clinical knowledge regarding the link between partial UPJO and changes in blood pressure, it is proposed that today's non-operative management of hydronephrosis should be reconsidered to reduce the risk of developing elevated blood pressure or hypertension in later life.
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Affiliation(s)
- Mattias Carlström
- Department of Physiology and Pharmacology Karolinska Institutet Stockholm Sweden
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Chang YJ, Chen WC, Chiang JH, Su YC, Tsai KS, Man KM, Tsai MY, Chen YH, Chen HY. Traditional Chinese medicine decreases the obstructive uropathy risk in uterovaginal prolapse: A nationwide population-based study. Medicine (Baltimore) 2018; 97:e12369. [PMID: 30235697 PMCID: PMC6160251 DOI: 10.1097/md.0000000000012369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Traditional Chinese medicine (TCM) is a popular treatment for voiding dysfunction in Eastern countries. However, no previous studies have investigated the effects of TCM on preventing obstructive uropathy in uterovaginal prolapse women. We conducted a large-scale nationwide population-based cohort study to investigate the relationship between TCM and obstructive uropathy in uterovaginal prolapse women. This is a retrospective cohort study with the Taiwan National Health Insurance Research Database (NHIRD). The study population was newly diagnosed uterovaginal prolapse patients between 1997 and 2010 year. Among patients, 762 uterovaginal prolapse patients in this cohort. Significant adjusted HRs of urine retention or hydronephrosis in Cox proportional hazard models were uterovaginal prolapse (hazard ratio [HR]: 1.74, 95% confidence intervals [CI]: 1.43-2.14), age 40 to 64 years (1.51, 1.01-2.27), ≥60 years (3.52, 2.32-5.34), DM (1.52, 1.23-1.89), hypertension (1.38, 1.13-1.7), constipation (1.35, 1.05-1.75), urinary tract calculi (1.54, 1.06-2.23), and TCM users (0.34, 0.28-0.41). The Kaplan-Meier analysis showed a higher incidence rate of urine retention or hydronephrosis in the uterovaginal prolapse cohort compared with that of the without uterovaginal prolapse cohort. The results of this nationwide population-based study support a relationship between TCM and a reduced risk of obstructive uropathy in uterovaginal prolapse women.
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Affiliation(s)
- Yin-Jen Chang
- Departments of Chinese Medicine, Urology, Medical Research, Obstetrics and Gynecology, and Anesthesiology
| | - Wen-Chi Chen
- Departments of Chinese Medicine, Urology, Medical Research, Obstetrics and Gynecology, and Anesthesiology
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, Research Center for Chinese Medicine & Acupuncture
| | - Jen-Huai Chiang
- Management Office for Health Data, China Medical University Hospital
- College of Medicine, China Medical University
| | - Yuan-Chih Su
- Management Office for Health Data, China Medical University Hospital
- College of Medicine, China Medical University
| | - Kao-Sung Tsai
- Departments of Chinese Medicine, Urology, Medical Research, Obstetrics and Gynecology, and Anesthesiology
- Department of Applied Cosmetology, Hungkuang University
| | - Kee-Ming Man
- Departments of Chinese Medicine, Urology, Medical Research, Obstetrics and Gynecology, and Anesthesiology
| | - Ming-Yen Tsai
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, Research Center for Chinese Medicine & Acupuncture
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung
| | - Yung-Hsiang Chen
- Departments of Chinese Medicine, Urology, Medical Research, Obstetrics and Gynecology, and Anesthesiology
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, Research Center for Chinese Medicine & Acupuncture
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Huey-Yi Chen
- Departments of Chinese Medicine, Urology, Medical Research, Obstetrics and Gynecology, and Anesthesiology
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, Research Center for Chinese Medicine & Acupuncture
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5
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Kazama I, Nakajima T. Postrenal acute kidney injury in a patient with unilateral ureteral obstruction caused by urolithiasis: A case report. Medicine (Baltimore) 2017; 96:e8381. [PMID: 29069033 PMCID: PMC5671866 DOI: 10.1097/md.0000000000008381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
RATIONALE In patients with bilateral ureteral obstruction, the serum creatinine levels are often elevated, sometimes causing postrenal acute kidney injury (AKI). In contrast, those with unilateral ureteral obstruction present normal serum creatinine levels, as long as their contralateral kidneys are preserved intact. However, the unilateral obstruction of the ureter could affect the renal function, as it humorally influences the renal hemodynamics. PATIENT CONCERNS A 66-year-old man with a past medical history of hypertension and diabetes mellitus came to our outpatient clinic because of right abdominal dullness. DIAGNOSES Unilateral ureteral obstruction caused by a radio-opaque calculus in the right upper ureter and a secondary renal dysfunction. INTERVENTIONS As oral hydration and the use of calcium antagonists failed to allow the spontaneous stone passage, extracorporeal shock wave lithotripsy (ESWL) was performed. OUTCOMES Immediately after the passage of the stone, the number of red blood cells in the urine was dramatically decreased and the serum creatinine level almost returned to the normal range with the significant increase in glomerular filtration rate. LESSONS Unilateral ureteral obstruction by the calculus, which caused reflex vascular constriction and ureteral spasm in the contralateral kidney, was thought to be responsible for the deteriorating renal function.
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Affiliation(s)
- Itsuro Kazama
- Department of Physiology, Tohoku University Graduate School of Medicine, Seiryo-cho, Aoba-ku
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6
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Carlström M. Causal link between neonatal hydronephrosis and later development of hypertension. Clin Exp Pharmacol Physiol 2010; 37:e14-23. [DOI: 10.1111/j.1440-1681.2009.05267.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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7
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Malouin A, Milligan JA, Drobatz KJ. Assessment of blood pressure in cats presented with urethral obstruction. J Vet Emerg Crit Care (San Antonio) 2007. [DOI: 10.1111/j.1476-4431.2006.00178.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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8
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Hernández-Llamas G, Palafox-Cervantes G, Borboa-Osuna AL, Urrecha-Manzano J, Cruz C, Pedraza-Chaverrí J, Cuetos-Martínez C. Role of the renin-angiotensin system in arterial hypertension secondary to acute unilateral urinary obstruction. Ren Fail 1994; 16:673-9. [PMID: 7899578 DOI: 10.3109/08860229409044896] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Acute unilateral ureteral obstruction (AUUO) has been associated to a blood pressure increase, presumably secondary to activation of the renin-angiotensin system (RAS), since the obstructed kidney increases renin secretion (Ref. 8). In an attempt to delineate the role of the RAS in this hypertensive model, we acutely obstructed the ureter in two groups of dogs that previous to the obstruction received either placebo (G I, n = 8) or 50 mg of captopril, an angiotensin-converting enzyme inhibitor (G II, n = 9). Animals that received placebo showed a consistent increase in mean arterial pressure (MAP), 128 +/- 4 vs. 144 +/- 4 mm Hg (p < 0.001); those that received captopril did not show such a tendency: 135 +/- 7 vs. 135 +/- 7 mm Hg. In further studies, three groups of animals were included: group III (G III, n = 4), identical to G I except that plasma renin activity (PRA) and aldosterone (ALDO) were measured; Group IV (G IV, n = 5), identical to G II except that they received 50 mg of indomethacin, 60 min before captopril; and group V (G V, n = 6), which was sham operated and measured for PRA and ALDO.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- G Hernández-Llamas
- Unidad de Medicina y Cirugía Experimental, Universidad Autónoma de Sinaola, Mexico
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9
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Szmuk P, Guy M, Ezri T, Soroker D, Eisenkraft S. Hypertension and pulmonary oedema due to hyperreninemia - an uncommon presentation of blunt abdominal trauma. Urologia 1993. [DOI: 10.1177/039156039306000315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We present an uncommon case of a child with acute abdominal signs, hypertension and pulmonary oedema, following blunt abdominal trauma. The clinical picture was due to rupture of a renal cyst and excess renin secretion from a unilateral, obstructed hydronephrotic kidney. Three months after nephrectomy the patient was normotensive.
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Affiliation(s)
- P. Szmuk
- Department of Anesthesia - Kaplan Hospital - Rehovot - Israel
| | - M. Guy
- Department of Urology - Kaplan Hospital - Rehovot - Israel
| | - T. Ezri
- Department of Anesthesia - Kaplan Hospital - Rehovot - Israel
| | - D. Soroker
- Department of Anesthesia - Kaplan Hospital - Rehovot - Israel
| | - S. Eisenkraft
- Department of Urology - Kaplan Hospital - Rehovot - Israel
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10
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Gabow PA, Chapman AB, Johnson AM, Tangel DJ, Duley IT, Kaehny WD, Manco-Johnson M, Schrier RW. Renal structure and hypertension in autosomal dominant polycystic kidney disease. Kidney Int 1990; 38:1177-80. [PMID: 2074659 DOI: 10.1038/ki.1990.330] [Citation(s) in RCA: 132] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Hypertension has been reported to occur in 50 to 75 percent of subjects with autosomal dominant polycystic kidney disease (ADPKD) prior to the onset of marked renal insufficiency but concurrent with cystic deformation of the renal parenchyma. The present study was undertaken to examine whether the renal structural abnormalities are greater in hypertensive (HBP) versus normotensive (NBP) male and female patients with ADPKD who were matched within gender groups for age, body surface area, serum creatinine concentration (males HBP 1.2 +/- 0.02 vs. NBP 1.1 +/- 0.03 mg/dl. NS: females HBP 0.9 +/- 0.03 vs. NBP 0.9 +/- 0.02 mg/dl, NS) and creatinine clearance (males HBP 100 +/- 3 vs. NBP 108 +/- 3 ml/min/1.73 m2, NS: females HBP 97 +/- 3 vs. NBP 96 +/- 2 ml/min/1.73 m2, NS). Renal volume was significantly greater in the HBP compared to the NBP group (males HBP 624 +/- 47 vs. NBP 390 +/- 43 cm3, P less than 0.0005; females HBP 446 +/- 32 vs. NBP 338 +/- 24 cm3, P less than 0.002). Since increased renal volume is due to increased cysts, the results indicate that the early high incidence of hypertension in ADPKD correlates with the renal structural abnormalities in this disorder.
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Affiliation(s)
- P A Gabow
- University of Colorado School of Medicine, Denver
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11
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Affiliation(s)
- D C Stair
- Yale University School of Medicine, Section of Cardiology, New Haven, CT
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12
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Sosa RE, Vaughan ED. Hypertension of renal origin. World J Urol 1989. [DOI: 10.1007/bf01576888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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13
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Pezzulli FA, Purnell FM, Dillon EH. Post-traumatic unilateral hydronephrosis with hypertension treated by embolization. Urology 1989; 33:70-3. [PMID: 2911933 DOI: 10.1016/0090-4295(89)90073-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
A case of post-traumatic renal hypertension secondary to unilateral hydronephrosis is presented. The patient was treated with embolization of the renal artery and remains normotensive two years after the procedure.
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Affiliation(s)
- F A Pezzulli
- Department of Radiology, Lenox Hill Hospital, New York, New York
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14
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Ezzat M. The pattern of plasma renin activity and aldosterone system in patients with sustained hydronephrosis. Int Urol Nephrol 1987; 19:55-63. [PMID: 3294713 DOI: 10.1007/bf02549678] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Twenty-six patients with unilateral and bilateral hydronephrosis were subjected to investigation to identify the patterns of PRA-aldosterone system. The incidence of hypertension in the unilateral group was 28.5%, while in the bilateral group it was 50%; the overall incidence was 34.6%. In the hypertensive patients (9 cases), plasma renin activity and aldosterone were normal in one, and elevated in three. Aldosterone only was elevated in 3 cases, while PRA was elevated in 2. In the normotensive patients, the levels of PRA and aldosterone were normal in 5 patients, while in the remaining 12 cases one or both parameters were elevated.
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15
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16
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Abstract
Two middle-aged men were referred for control of severe hypertension, presumed to be 'essential'. Late-onset enuresis, a small palpable bladder, and slight prostatic enlargement were elicited in one patient; history and examination were unremarkable in the other patient, apart from moderate prostatic enlargement. Intravenous urography revealed massive bilateral hydronephrosis with hydroureters in both patients. Surgical relief of retention was associated with post-obstructive diuresis and normalization of blood pressure, although recurrence of hypertension occurred later in one patient. These patients suffered from high pressure chronic retention, a syndrome characterized by impairment of renal function and hypertension. Surgical relief of retention was accompanied by prompt correction of hypertension, and gradual, sustained recovery of renal function.
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17
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Abstract
We report 2 cases of hypertension associated with unilateral hydronephrosis. Lateralization of renal vein renins and exaggerated hyperreninemia following captopril suggested renin-mediated hypertension in 1 case, which responded well to nephrectomy.
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18
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Abstract
A case is described, believed to be the first reported, of a newborn in whom severe hyperreninemic hypertension developed after pyeloplasty of a hydronephrotic kidney. Management of the hypertension required large doses of antihypertensive agents, including sodium nitroprusside, for six postoperative days. Propranolol had to be given for eight months after surgery. The possibility that thiocyanate level in a newborn is unreliable as indicator of sodium nitroprusside overdosage is considered.
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19
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Henderson IW, Oliver JA, Milne CM, Balment RJ. Incidence and some functional characteristics of hydronephrosis in Brattleboro rats. Ann N Y Acad Sci 1982; 394:21-9. [PMID: 6960759 DOI: 10.1111/j.1749-6632.1982.tb37407.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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20
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Hendren WH, Kim SH, Herrin JT, Crawford JD. Surgically correctable hypertension of renal origin in childhood. Am J Surg 1982; 143:432-42. [PMID: 7041669 DOI: 10.1016/0002-9610(82)90192-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Since 1960, 22 children were treated for surgically correctable hypertension or renal origin. The series included two children with tumors, two with hydronephrosis from ureteropelvic junction obstruction, nine in whom one kidney was atrophic, and nine with renal artery narrowing from fibromuscular dysplasia (with bilateral involvement in two). Hypertension was cured in the cases with tumors and ureteropelvic junction obstruction. It was also cured in four of the nine patients with an atrophic kidney and in five of the nine with a narrow renal artery. In those not cured hypertension was more easily controlled by medication. One patient died from brain hypoxia during surgery. About 10 percent of the children investigated for hypertension at the Massachusetts General Hospital proved to have a surgically correctable cause of renal origin.
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MESH Headings
- Adolescent
- Child
- Child, Preschool
- Female
- Humans
- Hydronephrosis/complications
- Hydronephrosis/surgery
- Hypertension, Renal/diagnostic imaging
- Hypertension, Renal/etiology
- Hypertension, Renal/surgery
- Infant
- Infant, Newborn
- Infant, Newborn, Diseases/diagnostic imaging
- Infant, Newborn, Diseases/surgery
- Kidney/diagnostic imaging
- Kidney/pathology
- Kidney/surgery
- Male
- Renal Artery/diagnostic imaging
- Renal Artery/surgery
- Respiratory Distress Syndrome, Newborn/complications
- Suture Techniques
- Ureteral Obstruction/complications
- Ureteral Obstruction/diagnostic imaging
- Ureteral Obstruction/surgery
- Urography
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21
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Urologic Aspects of Renal Hypertension. ARTERIAL HYPERTENSION 1982. [DOI: 10.1007/978-1-4612-5657-1_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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22
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Abstract
Renin-mediated hypertension can occur with unilateral renal obstruction and hydronephrosis. Elevated peripheral plasma renin activity and a lateralizing renal vein renin relationship represent a hormonal pattern suspiciously suggestive of a renovascular etiology. We report a case of surgically corrected renin-mediated hypertension secondary to ureteropelvic junction obstruction. Hyperreninemia associated with acute unilateral hydronephrosis probably occurs transiently to initiate chronic hypertension sustained by more complex volume-vasoconstriction abnormalities. The participation of renin in this hypertension seems to be influenced by the duration of the obstruction, the presence or absence of a contralateral normal kidney and other intrarenal factors.
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23
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Lüscher T, Vetter H, Pouliadis G, Kuhlmann U, Studer A, Hauri D, Wicky B, Schmitt I, Satz N, Siegenthaler W, Vetter W. Rare forms of renal hypertension. KLINISCHE WOCHENSCHRIFT 1981; 59:35-45. [PMID: 7007720 DOI: 10.1007/bf01477328] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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24
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Pak K, Kawamura J, Yoshida O. Hypertension with elevated renal vein renin secondary to unilateral hydronephrosis. Urology 1980; 16:499-501. [PMID: 7003901 DOI: 10.1016/0090-4295(80)90605-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
A case of hypertension secondary to unilateral hydronephrosis is reported. Renin levels were elevated in peripheral veins and in the renal vein draining the affected kidney. An infusion of angiotensin II analogue resulted in a decrease in blood pressure. After nephrectomy, blood pressure and peripheral plasma renin activity returned to normal. Renal vein renin and angiotensin II analogue studies were useful in the diagnosis and evaluation of curability by surgery in this case.
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25
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Pranikoff K, Rabinowitz R, Kamm DE, Segal AJ. Hypertension secondary to massive upper pole hydronephrosis. J Urol 1980; 124:701-3. [PMID: 7005461 DOI: 10.1016/s0022-5347(17)55615-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Hypertension secondary to hydronephrosis is uncommon, and when a duplex system is involved it is rare. A patient presenting with hypertension and an abdominal mass on the left side was found to have a non-functioning, massively dilated upper pole of a duplex system causing hyperreninemic hypertension. Treatment consisted of an upper pole partial nephrectomy. This unique case is discussed and the literature regarding hypertension secondary to hydronephrosis is reviewed.
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26
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Abstract
A patient who presented with hypertension of recent onset was found to have unilateral hydronephrosis. Increased activity of the renin-angiotensin system was documented with renal-vein-renin concentrations. The hydronephrosis was due to a primary transitional cell carcinoma of the ureter. Following nephroureterectomy, blood pressure returned to normal and has remained so for two years.
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27
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Leumann EP. Blood pressure and hypertension in childhood and adolescence. ERGEBNISSE DER INNEREN MEDIZIN UND KINDERHEILKUNDE 1979; 43:109-83. [PMID: 394960 DOI: 10.1007/978-3-642-67379-5_4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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28
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Uhari M, Remes M, Lanning P, Seppänen J. Severe hypertension in a patient with unilateral obstructive hydronephrosis and renal artery stenosis. J Pediatr 1978; 93:458-9. [PMID: 690763 DOI: 10.1016/s0022-3476(78)81161-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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