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Reversible renin-dependent renovascular hypertension successfully treated with percutaneous transluminal renal angioplasty and stenting.

Abstract
A 37-year old woman was suspected of having renovascular hypertension because of recent onset severe hypertension (blood pressure 220/135 mmHg; compared to 132/65 mmHg two years earlier) and an abdominal bruit. A captopril renal scan indicated the presence of right renal artery stenosis. Additionally, a captopril plasma renin activity (PRA) provocation test showed a positive result for renovascular hypertension (baseline PRA = 291 microU/mL; 1 hour post-captopril PRA = 1444 microU/mL). Selective renal angiography demonstrated a severe critical stenotic lesion at the distal portion of the right renal artery. Blood pressure (BP) decreased to 136/80 mmHg one day after successful percutaneous transluminal renal angioplasty and stenting. Repeat renal angiography six months after the procedure revealed no evidence of in-stent restenosis. Blood pressure (BP = 137/76 mmHg) and plasma renin profile (baseline PRA = 23.8 microU/mL; 1 hour post-captopril PRA=22.3 microu/mL) also were normal six months following initial revascularization. Moreover, blood pressure (137/84 mmHg) and renin profile remained normal 2.5 years after the procedure (baseline PRA = 24.3 microU/mL; 1 hour post-captopril = 25.6 microU/mL). The results of this study have thus demonstrated a case of renin-dependent renovascular hypertension in which both the blood pressure and plasma renin activity profile normalized following successful percutaneous transluminal angioplasty and stenting.
AuthorsBer-Ren Fang, Chin-Yew Lin
JournalInternational heart journal (Int Heart J) Vol. 46 Issue 2 Pg. 339-45 (Mar 2005) ISSN: 1349-2365 [Print] Japan
PMID15876819 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Renin
Topics
  • Adult
  • Angioplasty, Balloon (methods)
  • Female
  • Humans
  • Hypertension, Renovascular (blood, therapy)
  • Radiography
  • Renal Artery (diagnostic imaging)
  • Renal Artery Obstruction (complications, diagnostic imaging)
  • Renin (blood)
  • Stents

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