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Delayed hypertension after blunt renal trauma.

A Meyrier¹, M Rainfray, M Lacombe

¹Service de Néphrologie et d'Hémodialyse, Hôpital Avicenne, Bobigny, France.

American Journal of Nephrology

|January 1, 1988

Summary

Blunt renal trauma can cause severe hypertension years later due to renal artery damage. Surgical removal of damaged kidney sections normalized blood pressure in patients, highlighting trauma as a key cause of renovascular hypertension.

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Area of Science:

Nephrology
Cardiology
Trauma Surgery

Background:

Renovascular hypertension is a significant cause of secondary high blood pressure.
Blunt renal trauma is often not recognized as a cause of delayed hypertension.

Observation:

Four patients developed severe hypertension 2-32 years after blunt renal trauma.
Intravenous pyelography underestimated renal artery branch dissection and infarcts.
Angiography revealed traumatic dissection of renal artery branches leading to renal infarcts.

Findings:

Unilateral high renin secretion was detected in 3 patients.
Renin granules were confirmed in infarcted zones via immunofluorescence in one case.
Nephrectomy (total or polar) normalized blood pressure in all patients.

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Implications:

Blunt renal trauma is an underappreciated cause of renovascular hypertension.
Prompt diagnosis and intervention for renal artery lesions post-trauma are crucial.
Surgical management can effectively treat hypertension secondary to renal trauma.