Blunt renal trauma-induced hypertension: prevalence, presentation, and outcome

Blunt renal trauma (RT) may cause hypertension. We assessed the frequency and mechanisms of RT, and blood pressure (BP) outcome after treatment.

We searched the records of all patients referred to our hypertension unit and included those of previously normotensive patients who developed hypertension within 6 months of RT.

Ten of the 17,410 referred patients, with a median age of 26 years, developed hypertension 0 to 3 months after a well-documented RT. Median BP at referral was 170/107 mm Hg. Median glomerular filtration rate was 89 mL/min. Five patients had hematuria. Median kidney length was 107 mm on the damaged side and 114 mm on the opposite side. Renal artery lesions were present in six cases. A pattern of unilateral renin hypersecretion and contralateral suppression was present in five of eight cases with unilateral RT. Six patients underwent surgery. Seven months after referral, median BP was 128/79 mm Hg. The BP was <140/90 mm Hg without medication in one patient who did not undergo surgery and in three patients who did.

Renal trauma is a rare cause of hypertension, mostly in young men. Hypertension is usually renin dependent and associated with parenchymal injury. The RT-induced hypertension may resolve spontaneously and is amenable to surgery.